婴幼儿法洛氏四联症根治术53例经验总结

Experience of Total Repair for Tetralogy of Fallot in Infancy

目的 总结我院近5年完成的53例婴幼儿法洛氏四联症根治术的临床经验。方法 2003年3月-2007年8月，我院共完成婴幼儿法洛氏四联症根治术53例，男35例、女18例、年龄6个月-2岁，体重6～15kg。（10±1.5kg）全部经右心室流出道切口完成疏通。结果 全组53例婴幼儿法洛氏四联症根治术成功51例．早期死亡2例，手术早期死亡率3.7％无晚期死亡。死亡原因：严重低心排综合症1例，急性呼吸窘迫综合症1例。8例发生较严重的并发症，包括二次气管插管2例，肺部感染5例，急性呼吸窘迫综合症3例，急性肾功能衰竭需腹膜透析治疗2例，低心排综合症5例、乳糜心包1例。结论 在婴幼儿期进行TOF根治术同样可以取得满意的，临床结果。呼吸系统并发症是婴幼儿法乐四联根治术后面，临的主要问题之一。

Objective To review the experience of total repair for tetralogy of fallot （TOF） in infancy. Methods Between March ,2003 and Aug. 2007,53 infants（ male 35 ,female 18） underwent total repair of TOF, the infants were aged from 6 to 24 months, and weighted from 6 to 15kg. All procedures were completed using cardiopulmonary bypass （CPB）with a transventricular approach. Results The crossclamp time was 45 to 85 [mean （63±15）mins],the duration of CPB was from 60 to 140 [mean （70±24） mins],2 died after operation , 1 of low cardiac output syndrome（LOS）, and 1 acute respiration distress syndrome（ARDS） ,the mortality was 3.7%. Conclusion The results of total repair for TOF in infancy are satisfactory. ARDS is still one of the most common complications we should deal with.