法洛四联症合并肺动脉闭锁的手术治疗分析

Analysis Surgical Treatment of Tetralogy of Fallot with Pulmonary Atresia

目的:探讨法洛四联症合并肺动脉闭锁的手术治疗,对其各型手术时机、手术方法进行概述。方法:在我院就诊的21例法洛四联症合并肺动脉闭锁患者,15例患者在全身麻醉中度低温体外循环下实行一期根治术,6例患者实行分期手术。结果:3例发生术后早期死亡,Ⅲ型患者2例,Ⅳ型患者1例,死亡原因:低心排血量综合征1例,灌注肺1例,严重感染1例。16例保持长期随访,随访0.6-4年,NYHA心功能都达到Ⅰ或Ⅱ级标准。结论:法洛四联症合并肺动脉闭锁确诊后,根据肺动脉发育情况选择合适的手术方式尽快手术,能提高患者的治愈率,降低病死率。

Objective： To investigate the tetralogy of Fallot with pulmonary atresia surgical treatment, outlined its various types of timing of surgery, surgical methods. Methods： 21 cases of tetralogy of Fallot with pulmonary atresia patients doctor in our hospital were included into our study. 15 patients carried out one-stage radical operation under the condition of general anesthesia moderate hypothermic cardiopulmonary bypass, 6 patients implemented the staging surgery. Results： 3 patients had early postoperative deaths, including 2 III type patients,1 1V type patients.The causes of^death were： 1 case of low cardiac output syndrome, 1 case of lung perfusion, 1 case of se- vere infection. 16 cases have long-term follow-up for 0.6-4 years, NYH heart function have reached I or II standard. Conclusion： After diagnosis of tetralogy of Fallot combined with pulmonary atresia, choosing the appropriate surgical approach as soon as possible accord- ing the pulmonary artery development situation can improve the cure rate and reduce mortality.