根治婴儿法洛四联症新术式临床研究

Clinical study on radical surgery for tetralogy of fallot in 43 cases infancy with new technique

目的探讨经主肺动脉和右心房径路根治婴儿法洛四联症（TOF）新术式的适应证和疗效。方法 43例TOF婴儿,经主肺动脉、右心房径路行TOF根治术,占同期婴儿TOF根治手术的76.8%（43/56）。结果 43例婴儿全部痊愈出院,术后仅需要小剂量多巴胺辅助循环,无严重并发症。随访1～62个月,患儿正常生长、发育,心功能良好,无死亡,无需要二次手术者。结论肺动脉瓣环发育良好的TOF婴儿可以通过主肺动脉、右心房切口进行根治术,能够保持肺动脉瓣完整性、避免右心室切口,手术后右心功能良好,围手术期并发症少,无死亡,取得满意近、中期手术疗效。

Objective To explore the indications and results of the operations by through main pulmonary artery and right atrial repair of tetralogy of Fallot（ TOF） under one year of age. Methods 43 TOF cases underwent main pulmonary and transatrial repair of tetralogy of Fallot.Results All infancy were very well postoperatively. Only small dose of dopamine was used to support the hearts. Postoperative followed up time is about 1 ～ 62 months. No death was reported in all these patients. No need for secondary surgery in all these patients. Conclusion The operation of TOF can be performed through main pulmonary and transatrial repair under one year of age. In this technique,it can protect right ventricle function. The recent and interim efficacy of this operation were very good.