小体重法乐氏四联症的外科治疗

Surgical treatment of tetralogy of Fallot in low-weight infants

目的研究8kg以下小体重法乐氏四联症(F4)患儿的围手术期治疗措施,以及其对提高术后治愈率的影响,以指导今后的工作。方法对1995年8月—2010年8月,在全麻、低温、体外循环下行手术治疗的96例体质量<8kg的F4病例进行分析研究。其中男性52例,女性44例,年龄30d～3岁。全组96例患儿采用气管插管、静脉复合麻醉、低温体外循环并经主动脉根部灌注晶体停跳液。采用胸部正中切口。全组患儿均采用主动脉、右房上、下腔插管建立体外循环,全部患儿在阻断前常规建立左心引流。结果早期死亡2例,占2.2%。随访94例,采用来院复查方式。随访时间:术后3个月～13年,随访至13年时有49例得到随访复查,45例失访。随访到患儿均能正常生活,心功能Ⅰ级,右室流出道通畅,无残余分流。结论小体重量F4在围手术期整体管理对于手术成功率具有重大意义。

Objective To summarize the experience of surgical treatment in 96 infants with tetralogy of Fallot,all cases weight below 8 kilograms.Methods 96 cases of tetralogy of Fallot underwent heart surgery correctly from August 1995 to August 2010.There were 52 male and 44 female at the age ranged from 30 days to 3 years,all cases had been conducted by corrective operation under deep hypothermic and air esthesia.Results 2 cases died in the early postoperative period.The mortality rate was 2.20%（2/96）.94 cases were followed up and discharged without any complication.Conclusion Correctly perioperative management is meaningful to increase surgical successful rate.