婴幼儿法洛四联症的外科治疗

Surgical treatment of tetralogy of Faollot in infants and younger children

目的总结婴幼儿法洛四联症（TOF）一期根治术的治疗经验，以提高婴幼儿TOF一期根治术的成功率。方法自2003年2月至2006年6月，我科共收治〈3岁的TOF患儿21例，其中男13例，女8例。术前均经二维超声心动图或心导管造影确诊，所有患者均在中低温体外循环下行一期根治手术。结果本组无手术近期死亡，术后并发症包括低心排1例，呼吸窘迫综合征1例，心律失常1例。16例患者术后随访3～12个月，紫绀消失，生长发育明显加快，均恢复良好。结论婴幼儿TOF行一期根治术安全可靠，改进手术方式，注意术中心肌保护及术后监护是使患者手术成功的重要保证。

Objective To explore the experience with primary radical operation of tetralogy of Faollot （TOF） in infants and younger children, in order to improve the successful rate. Methods Twenty -one infants and children younger than three years（ thirteen males and eight females）underwent primary radical correction of TOF at our department from January 2003 to June 2006 were diagnosed through two - dimensional and doppler echocardiography or cardioangiography. Primary radical operation was performed on all the cases under moderate -hypothermic cardiopulmonary bypass. Results No patient died in the group, one case was complicated with low cardiac output syndrome , one with respiratory distress syndrome , one with arrhythmia. Sixteen cases were followed up survey for 3 - 12 months postoperatively and all were recovered well with cyanosis disappearance and improved in growth development significantly. Conclusion It is safe and reliable of primary radical operation for TOF in infants and younger children. Improving surgical technique, paying attention to myocardical protection during operation and postoperative care wiuattribute to the successful repair of TOF in infants and younger children.