141例婴幼儿法乐氏四联症手术临床研究  

Clinical Study on Operation of TOF in 141 Pediatric Patients

作　　者：闪辉[1] 王平凡[1] 李永武[1] 朱汝军[1] 梁凯[1] 谌启辉[1] 刘志永[1] 

机构地区：[1]河南省胸科医院心外科,郑州市450008

出　　处：《医药论坛杂志》2006年第11期20-22,共3页Journal of Medical Forum

摘　　要：目的 本文探讨了141例就治年龄小于3岁，其中小于1岁者48例的法乐氏四联症手术治疗相关经验。方法 2001年1月-2005年12月收治141例就治年龄小于3岁法乐氏四联症患者，体重4．0-15kg，平均（12±2．8）kg。4例患者行估息分流手术，123例在中、深低温体外循环下施术，深低温停循环14例。近期20例患者经三尖瓣途径疏通右心室流出道及修补室间隔缺损。近期手术中27例常规应用改良超滤技术。结果 手术死亡7例，1例死于灌注肺，2例死于心包腔内感染，4例死于同低心排相关的急性肾功能衰竭和毛细血管渗漏综合征，手术死亡率4．8％。结论 体外循环和手术技术的提高拓宽了手术适应证。婴幼儿TOF手术成功率的进一步提高得益于心肌保护，特别是心肌有形组织保护技术的改进以及更仔细的右心室流出道的建设和更先进体外循环技术的帮助。Objective This study was conducted to describe the experience of operation of TOF in 141 Pediatric patients whose age 〈 3 years old ,arnong them 48 cases 〈 1 year old. Methods From Jan. 2001 to Sept. 2005,141 pediatric patients 85 boys and 56 girls,aged 2 months to 3 yrs, with body weights of 4 to15 kg,mean（ 12± 2.8）kg. 123 cases were corrected under deep hypothermia with low flow or arrest CPB , 4 cases with palliative operation. Latest 20 cases subpulmonary resection and ventricular septel defect closure were accomplished transatrilly, 27 cases modified uhrafiltration during cardiopulmonary bypass were used. Results There are 7 postoperative deaths（4. 8% ）. 1 case died of respiratory distress syndrome ,2 cases died of pericarditis infection ,4 cases died of low cardiac output. Conclusion Good operation magement is related to right choice, reasonable correction of the anomalies, effective perioperative protection of the heart and lung function.

关 键 词：婴幼儿 法乐氏四联症 手术治疗 

分 类 号：R654.2[医药卫生—外科学]