105例法洛四联症外科治疗体会

Experience of surgical treatment of 105 patients with tetralogy of Fallot

目的:总结105例法洛四联症(TOF)外科治疗经验。方法:2000年1月～2008年12月我院对105例法洛四联症患者实施手术治疗,男性68例,女性37例,年龄5个月～45岁,平均(10.2±6.8)岁。其中合并肺动脉闭锁1例,房间隔缺损(ASD)及卵圆孔未闭(PFO)32例,动脉导管未闭(PDA)10例,左上腔静脉畸形5例。所有患者均在全麻、低温、体外循环下行根治术,用Dacron补片修补室间隔缺损,自体心包片跨环补片扩大右室流出道及肺动脉98例,单纯扩大右室流出道7例。结果:术后早期死亡3例,死亡率2.86%,治愈出院102例。结论:术中右室流出道的充分疏通、良好的心肌保护是手术成功的关键;完善的围术期处理、低心排血量综合征(LCOS)的有效防治,是降低死亡率的重要措施。

Objective： To summarize the experience of surgical treatment on 105 patients with tetralogy of Fallot. Methods： One hundred and five cases of tetralogy of Faltot underwent heart surgery correctly from January 2000 to December 2008. There were 68 males and 37 females at the age ranged from 5 month to 45 years, average（10.2±6.8）yr, all cases had been conducted by corrective operation under deep hypothermic and extracorporeal circulation, using Dacron patch was used to repair ventricular septal defect. Widening right- ventricular outlet and pulmonary trunk with pericardial patch on 98 cases. Results： Three cases died in the early postoperative period. The mortality rate was 2.86%（3/105）. 102 cases were discharged without any complication. Conclusion： Rebuilding unobstructed outflow of right ventricle and well heartprotection is the essential factor to the surgical success.