法洛四联症根治术65例临床回顾

CLINICAL RETROSPECTIVE STUDY OF RADICAL OPERATION OF TETRALOGY OF FALLOT

目的 通过对 6 5例法洛四联症根治术的回顾、分析 ,进一步探讨其手术适应症、手术技巧及术后处理方法。方法 6 5例患者不考虑左心室及肺动脉发育情况均施行法洛四联症根治术。结果 6 5例中治愈 6 1例 ,死亡 4例 ,术后各种并发症 2 4例。结论 左心室及肺动脉发育不良可增加手术后并发症的发生率但并不影响根治术的实施 ,故不应视为手术禁忌 ;术中疏通右室流出道 ,要尽量保持心肌收缩的物理结构和肺动脉瓣的完整性 ,避免三尖瓣返流 ,严密的室缺修补及合理的围术期处理 。

Objective To retrospect and analyse 65 cases of radical operations of tetralogy of Fallot so as to have a further study of the operative indications and skills as well as the postoperative treatment methods. Methods All of the 65 cases received radical operations of tetralogy of Fallot regardless of development condition of their left ventricle and pulmonary artery. Results Out of the 65 cases, 61 were cured, 4 died and various postoperative complications occurred to 24 cases. Conclusion Maldevelopment of left ventricle and pulmonary artery, which may increase the incidence of postoperative complications but doesn't influence the radical operation, should not be regarded as contraindication to the operation. When the right ventricular tract is deoppilated during operation, the physical structure of myocardial contraction and the pulmonary valve should be kept impact as much as possible to avoid backflow of tricuspid valve. Strict correction of ventricular defects and proper perisurgical treatment are important measures to decrease operative death rate.