法洛四联症的外科治疗体会(附45例报告)

Experiencein Surgical treatment on tetralogy of Fallot

目的总结45例法洛四联症患者外科治疗的经验体会。方法选取2004年6月至2010年6月于我院行手术治疗的45例患者,男25例,女20例,年龄6个月～45岁。1例合并肺动脉闭锁,房间隔缺损及卵圆孔未闭5例,动脉导管未闭3例,左上腔静脉畸形2例。全麻、低温、体外循环下对所有患者行根治术,室间隔缺损用Dacron补片修补,右心室的流出道和肺动脉的扩大用自体心包片,合并的心脏畸形做相应的矫正。结果术后早期死亡2例,43例治愈出院。结论法洛四联症患者应尽早行根治性手术。术中充分疏通右心室流出道、注重心肌的保护是手术成功的关键。细心的围手术期处理和有效防治低心排血综合征可有效降低死亡率。

Objective To summarize the experience of surgical treatment on 45 patients with tetralogy of Fallot.Methods 45 patients who underwent heart surgery in our hospital from Jun,2004 to Jun,2010 were involved in this research.There were 25 males and 20 females,and the age ranged from 6 month to 45 year.Surgical treatment was conducted under deep hypothermic and extracorporeal circulation,ventricular septal defect were repaired by using Dacron path.Pericardial patch were used to widening right-ventricular outlet and pulmonary trunk,and other abnormalities were also corrected.Results 2 cases died in the early postoperative period and 43 cases were discharged without any complication.Conclusion Patients with tetralogy of Fallot should undergo surgery as early as they can.Rebuilding unobstructed outflow of right ventricle and careful heart protection are the essential factors to the success of surgery.Careful perioperative management and prevent LCOS are important to decrease complications and lower mortality.