解剖矫正完全性房室间隔缺损合并法洛四联征的远期效果  

Long-term results of the total repair of atrioventricular septal defect complicated with tetralogy of Fallot

作　　者：张晶[1] 吴祖凯[1] 张为民[1] 谭杰[1] 李艳春[1] 李倩倩[1] 李健[1] 拜合提[1] 

机构地区：[1]新疆维吾尔自治区人民医院北院心脏中心,乌鲁木齐市830054

出　　处：《中华实用诊断与治疗杂志》2012年第12期1162-1164,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：新疆维吾尔自治区科技攻关项目(200833115)

摘　　要：目的评价解剖矫正完全性房室间隔缺损合并法洛四联征的远期效果。方法 11例完全性房室间隔缺损合并法洛四联征患儿,术前均有不同程度紫绀,1例有频繁缺氧发作,经皮血氧饱和度60%～85%,1例术前并发脑脓肿,4例伴明显肺动脉瓣及瓣环狭窄;术前共同瓣轻度反流2例、中度反流3例、重度反流2例;11例均采用右心房、右心室纵切口,二片法补片修补房室间隔缺损,左侧房室瓣裂隙采用间断缝合,右心室流出道加宽补片。结果手术后11例患儿紫绀均消失,经皮血氧饱和度均在95%以上;1例脑脓肿患儿先行脑脓肿治疗后再行矫正手术亦康复;术后超声检查显示2例二尖瓣少量反流,其中1例合并三尖瓣中度反流;术后早期无死亡;随访6个月～5a无死亡,患者NYHA心功能Ⅰ级或Ⅱ级。结论解剖矫正完全性房室间隔缺损合并法洛四征手术安全、远期效果好。Objective To evaluate the long term results of total repair of complete atrioventricular septal defect complicated with tetralogy of Fallot （CAVSD-TOF）. Methods Eleven patients underwent total repair of CAVSD-TOF. Before operation, cyanosis occurred in each patient in different degrees, one patient had frequent cyanotic spells attacks, one patient had brain abscess and four patients had valvar pulmonary stenosis. Echocardiographic examinations showed mild left atrioventricular valve insufficiency in two patients, moderate in three patients and severe in two patients. The atrioventricular septal defect was closed through right atriotomy and longitudinal right ventriculotomy with the two-patch technique for all cases. The mitral valve cleft was closed in each case. Right ventricular outflow tract obstruction was relieved by a transannular patch. Results After operation, there was no cyanosis in all patients with the saturation of over 95 %. Total repair was performed after the operation of brain abcess. Final echocardiographic examinations showed mild mitral regurgitation in two patients, and one of them has moderate tricuspid valve insufficiency. No death occurred in the early period after operation and in 6 months to 5 years＇ follow-up survey. Heart function （NYHA） was class I or II in all cases. Conclusion CAVSD-TOF can be repaired safely and effectively, and it has an excellent long-term result.

关 键 词：先天性心脏病 房室间隔缺损 法洛四联征 心脏矫正术 

分 类 号：R654.2[医药卫生—外科学]