法乐四联症缺氧发作的临床分析

The clinical analysis of hypoxic spells on patients with tetralogy of fallot

目的探讨法乐四联症缺氧发作的防治措施。方法通过对住院的23例法乐四联症急性缺氧发作患者的临床资料总结，分析缺氧发作诱因，探讨缺氧机制并提出防治措施。结果23例缺氧患者中死亡4例（17％）。缺氧发作诱因包括：（1）晨起或喂奶后不久；（2）啼哭和大便后突然站立；（3）气候炎热或感染发热；（4）贫血。发作机制可能是：（1）右心室漏斗肌肉收缩增加；（2）体循环阻力突然下降；（3）过度通气；（4）高粘度综合征。结论控制诱发因素和及时防治可减少法乐四联症缺氧发作。尽早手术治疗是根治缺氧发作的最好办法。

Objective To explore the prophylaxis and treatment of hypoxic spells on patients with TOF. Methods Retrospectively analysed and compared the case history of the inpatients with TOP in our hospital, to analyse the epilepticus cause of hypoxic spells and study the hypoxia mechanism and summarize the prevention and control measures. Results 4 （ 17 % ） cases of TOF died after hypoxie spells, the epilepticus cause of hypoxic spells included suckling, early getting up, crying, standing abruptly after stool, scorching climate, infection fever and anemia, the hypoxia mechanism was likely to the increase of infundibulum cardiac muscle contraction, the systemic circulation resistance drop suddenly, hyperventilation, high-viscosity syndrome. Conclusion To control the epilepticus cause and perform operative treatment early can reduce the hypoxic spells. The prevention and control measures were strengthening the live nurse, disconnected oxygen inhalation,oral beta-blocker therapy and venous injection 5 % sodium bicarbonate. Early operative treatment was the best redicai treatment.