成人法洛四联症根治术中远期疗效分析  

The medium and long term effect analysis of adult tetralogy of fallot with radical correction

作　　者：刘延华[1] 何发明[1] 梁志强[1] 郑向阳[1] 宋鹏[1] 王平凡[1] 

机构地区：[1]河南省胸科医院心血管外科,郑州市450003

出　　处：《中国心血管病研究》2013年第1期30-32,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的总结成人法洛四联症根治术经验，评估风险，分析其中远期疗效。方法2000年1月至2008年12月80例患者接受法洛四联症根治术，男性44例，女性36例，年龄18~45（26．2±5．6）岁。所有患者均在低温体外循环下手术，其中跨瓣环加宽34例，采用补片单纯加宽右室流出道46例。结果死亡2例（2．5％），二次开胸止血6例（7．5％）。随访36~120（平均58．5）个月，存活75例，死亡3例，其中2例术后1年、3年因心功能衰竭死亡，另1例术后16个月因交通事故死亡。存活的患者中，心功能I级47例，心功能Ⅱ级24例，心功能Ⅲ级4例。随访彩超，所有患者均无残余漏，肺动脉瓣跨瓣压差6～15（7．4±2．1）mmHg，轻一中度肺动脉瓣反流18例，重度肺动脉瓣反流3例。结论成人法洛四联症患者行根治手术死亡率较低，术后疗效满意，不应因患者的年龄而放弃治疗。Objective To review the clinical experience assess the risk and analyze the medium and long term effect in surgical treatment of tetralogy of fallot in adult patients. Methods From January 2000 to December 2008, 80 adult patients （44 males and 36 females） received radical correction. The age ranged from 18 to 45 （26.2±5.6）years old. All patients were treated with extracorporeal circulation operation, acrossing the pulmonary valve ring widened in 34 cases, simple widening right ventricular outflow tract in 46 patients. Results 2 patients died during hospitalization. Thoracotomy hemostasis were performed in 6 patients. 3 patients died and the other 75 patients survived during the follow-up of 36-120 （mean 58.5） months. Of all the survival patients the cardiac function of 47 cases were in NYHA class Ⅰ , 24 cases in class Ⅱ , 4 cases in class Ⅲ. There was no patient with residual shunt, mild to moderate pulmonary regurgitation in 18 patients, serious pulmonary regurgitation in 3 pa- tients. Conclusion Mortality is low in radical correction of tetralogy of fallot in adult patients and the results after surgical treatment are satisfactory. The treatment should not be given up due to the age of the patients.

关 键 词：法洛四联症 成人 外科手术 先天性心脏病 

分 类 号：R654.2[医药卫生—外科学]