62例法乐四联症根治术围术期处理

Peroperative management of radical correction of tetralogy of Fallot

目的 为提高法乐四联症的手术治疗水平 ,探讨右室流出道的疏通标准。方法 采用全麻、低温体外循环下对62例法乐四联症患者施行根治术。行右室流出道疏通及室间隔缺损闭合 ,应用以体重为标准的右室流出道疏通方法。结果 治愈 58例 ,随访 6个月～ 8年术后心功能满意。其中发生并发症 1 2例 ,包括低心排排出量综合征 4例 ,灌注肺 2例 ,三度房室传导阻滞 2例 ,术后残余分流 1例 ,胸水 3例 ,死亡 4例。结论 以体重为标准的右室流出道疏通及严密闭合室间缺损是手术成功的关键。平稳的体外。

Objective To improve the diagnosis and treatment of tetralogy of Fallot in children and adults and explore the criterion of widening right ventricular outflow tract. Methods 62 patients with tetralogy of Fallot had undergone radical correction of tetralogy of Fallot. The operation was performed under CPB hypothermia, excising heavy muscle bundles, the infundibular sepum thus widening. The size of the widening tract depends on weight criterion. Results 58 patients were healed, and the follow-up from 6 months to 8 years showed satisfied cardiac function. 12 patients with complication. Death in 4. Third degree A-V block in 2. Incomlete closure in 1. Conclusions The keyhole procedures in repair of tetralogy of Fallot is to close ventricular septal defects carefully and widening the ventricular outflow properly and carefully mornitoring after operation.