小儿和成人法乐四联症外科治疗的比较

The Surgical Treatment of Pediatric and Adult Tetralogy of Fallot

目的 :探讨小儿和成人法乐四联症外科治疗的临床经验。方法 :从 1998年 9月～ 2 0 0 3年 6月 ,对 2 5例不同年龄段的法乐四联症施行根治术 ,按年龄段分为两组 ,小于 14岁的为小儿组 ,大于 14岁的为成人组。全组中 16例使用补片扩大右心室流出道的病例中 ,14例采用涤沦布并自体心包补片 ,2例采用自体心包补片。结果 :小儿组 3例术后出现血压偏低、2例心律失常。成人组术后只 2例心律失常、2例胸液过多、2例肺渗出性改变。结论 :小儿和成人法乐四联症根治术各有其自身特点 ,掌握不同年龄段患者的特点 ,有针对性地改进手术技术和术后监护处理 ,可以提高手术成功率。

Objective:To summarize the experience of surgical treatment of tetralogy of Fallot(TOF)in children and adults.Methods:From September 1998 to June 2003,25 patients underwent radical operation for tetralogy of Fallot were divided into two groups:pediatic group with age less 14 years and adult group with age over 14 years.The outlet tracts of right ventricle were widened with Dacron and self-pericardial patch in 14 patients,with pericardial patch in 2 patients.Results:In pediatric group,3 patients had hypotension,2 arrhythmia.In adult group,2 patients had arrhythmia,2 excessive hydrothorax and 2 pulmonary edema with effusion.Conclusion:The radical operation for tetralogy of Fallot has different Characteristics between Childen and adults,and based on them we can improved surgical techniques,Postoperative managements and successful rate of operation.