法乐氏四联症根治术179例临床分析

Clinical Analysis of Radical Correction of Tetralogy of Fallot in 179 Cases

目的总结179例法乐氏四联症根治术手术经验。方法自1984年1个月—2007年3月行法乐氏四联症根治术179例,年龄4个月至34岁,体重5～60kg。全组140例于中低温体外循环阻断升主动脉下行根治术,39例于体外循环不阻断升主动脉下行根治术,比较主动脉阻断组与非阻断组术后的病死率。全组行肺动脉跨环补片32例,主肺动脉加宽补片2例,144例单纯右室流出道加宽补片。结果全组死亡23例,病死率12.8%。其中死于低心排12例,占死亡人数的52%。主动脉阻断组与主动脉非阻断组病死率分别为15.7%和2.6%,二者差异有统计学意义(P<0.05)。结论法乐氏四联症一期根治术可取得满意疗效,在畸形矫正彻底的前提下,主动脉非阻断的手术方法利于减少术后严重并发症的发生,降低手术的病死率。

Objective To review the experience of radical correction for tetralogy of Fallot. Methods 179 patients with tetralogy of fallot aged four months to thirty- four years were performed radical correction from 1984 to 2007. 140 of them were performed under the moderate hypothermia cardiopulmonary bypass, 39 of them without cross - clamped ascenting aort, and holding heart in stopping. 32 patients required transannular patch, 2 patients need enlargement in main pulmonary. 144 patients need enlargement in RVOT only. Results 23 cases died with an operative mortality 12.8%,12 of them died of low cardiac output syndrome. Conclusion The satisfactory effectness of radical correction of tetralogy of FaUot can be achieved. Technique without cross - damped ascenting aort can decrease the happening of severe complications after operation significantly.