法洛四联症不同手术年龄的手术效果随访评价

Evaluate the surgical effect of tetralogy of Fallot in different surgical ages

目的应用经胸超声心动图（TTE）随访不同手术年龄TOF患者的手术效果，以探讨TOF的最佳手术年龄。方法选取2种手术方式的TOF回访患者，分别按照不同的手术年龄分组：〈1岁组、1～4岁组、4～10岁组、10～18岁组、〉18岁组，将TTE测量情况进行组间比较。结果〈1岁组术后的RVAW／AO显著小于余各组，其RVOT及PV的Vmax及PGmax显著小于4岁以上者；LV／AO（术前）与PA／AO（术后）之间，10岁以上者变化最小；〉18岁组的MV-E／A显著小于10岁以下者，RV压力显著大于其余各组，而PRi亦显著大于10岁以下者；两组患者的LV／RV、LVEDVI各组间无显著性差异，且其LVEF、LVFS数值均在正常范围。结论婴儿期手术心脏恢复相对较好；年龄愈大，PA恢复愈差；成人期手术易引起RV压力增高及PR，并影响LV功能，应加强随访。

Objective To follow-up the surgical effect of TOF in different surgical ages by transthoracic echocardiography （rITE） , so to approach the best surgical age of TOF. Methods Choosing 72 patients who have finished primary repair of TOF in 2 groups with different surgical types, which have been derided into 5 groups respectively, according to different surgical age ： 〈 ly, 1 - 4y, 4 - 10y, 10 - 18y, 〉 18y, eomparision has been done during the 5 groups. Results The RVAW/AO of group（ 〈 1 y） is the smallest in whole patients after surgery; The Ymax and PGmax of RVOT and PV in group（ 〉4y）are larger than group（ 〈 ly）obviously; in group （ 〉 18y） ,MV-E/A is less than group（ 〈 10y） ,RV pressure is higher than the other groups,and PRi is larger than group（ 〈 10y）; There＇re no statistical differences in LV/RV and LVEDVI among the whole groups, and the LVEF and LVFS of the whole patients are normal. Conclusion Repair of TOF in infancy makes the recover- y of heart better; The larger surgical age is,the worse recovery of PA is; Surgery in adulthood may cause the worse LV function, higher right ventricular pressure and PR,whieh should be strengthen following up.