30岁以上法洛四联症外科治疗  

Surgical treatment of Tetralogy of Fallot in patients over 30 year

作　　者：王辉山[1] 汪曾炜[1] 朱洪玉[1] 张仁福[1] 宫汉东[1] 张南滨[1] 宋恒昌[1] 张静[1] 

机构地区：[1]沈阳军区总医院心血管外科,沈阳110015

出　　处：《心肺血管病杂志》2005年第3期150-152,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:总结回顾30岁以上中老年法洛四联症手术治疗经验。方法:50例30岁以上法洛四联症患者,年龄30～66岁,平均(34.7±6.10)岁,合并左上腔3例,右位主动脉弓6例,合并三尖瓣关闭不全1例,主动脉瓣关闭不全1例,房间隔缺损或卵圆孔未闭10例,右冠状动脉畸形1例,均行四联症心内修复术。妥善疏通右心室流出道,用涤纶或心包补片加宽右心室流出道,用涤纶补片修补室间隔缺损,并处理合并畸形。结果:手术死亡1例(2%),晚期死亡1例,其余患者心功能均得到不同程度的改善。结论:中老年四联症心力衰竭,严重红细胞增多症,高血压及高尿蛋白并非手术禁忌。良好的心肌保护和转流,完善的外科修复及严密的术后监护是手术成功的关键,近期和远期效果满意。Objective：To review the clinical experience in surgical treatment of Tetralogy of Fallot in adult patients over 30 years old. Method： 50 patients over 30 years old （range, 30-66 ） underwent correction repair for Tetralogy of Fallot. Concomitant cardiac anomalys, include left superior vena cava in 3 Cases, tricuspid regurgitation in 1, aortic regurgitation in 1 ,atrial septal defect in lO,anomaly in right coronary artery in 1.42 cases were performed to widen the right ventricular outflow with valved or no-valved patches and single repair of right ventricular outflow were used in 8 cases. Ventricular septal defects were repair with Dacron patches. Result ： 1 case died perioperatively and 1 died lately. Heart function were improved in other patients. Conclusion： Heart failure, hypertention, high levels of hemoglobin and urine protein are not the contraindication for total correction in adult Tetralogy of Fallot. Proper surgical treatment plays an important role in good result.

关 键 词：法洛四联症 心脏外科手术方法 中老年 手术期间 外科治疗 右心室流出道 涤纶补片修补 

分 类 号：R541.1[医药卫生—心血管疾病] R542.53[医药卫生—内科学]