法洛四联症根治术后再次手术56例原因分析  

Analysis of re-operation results after total correction of tetralogy of Fallot

作　　者：李轩[1] 姜睿[1] 闫鹏[1] 孔博[1] 尹朝华[1] 李巅远[1] 罗国华[1] 王强[1] 闫军[1] 

机构地区：[1]中国医学科学院北京协和医学院心血管病研究所阜外心血管病医院心外科,北京100037

出　　处：《心肺血管病杂志》2014年第2期172-177,共6页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:总结法洛四联症(TOF)根治术后再次手术的原因及其相关处理。方法 :2007年1月至2013年1月间,我院共对56例TOF根治术后的患者进行再次手术治疗,对其进行回顾性研究,分析再次手术的原因和处理方式。再次手术的原因包括:室间隔缺损残余分流、右心室流出道梗阻/肺动脉狭窄、三尖瓣反流、肺动脉瓣反流、右心室流出道瘤样扩张以及主动脉瓣反流等。结果:全组无死亡病例。中位住院天数26.2 d,中位ICU时间12.5 d。再次手术的效果满意。结论:提高手术技术、采用适当的心脏切口以及避免单纯使用新鲜的自体心包片,加宽右心室流出道等,可减少再次手术的机会。对这类患者加强随访,并对相关并发症进行积极处理。关于TOF的治疗策略,需要更进一步的临床研究。Objective：To study the reasons of re-operation after total correction of tetralogy of Fallot （TOF）.Methods：We retrospectively studied the patients with TOF receiving re-operations at Fu Wai Hospital from Jan.2007 to Jan.2013.The etiology and treatment were recorded.The follow-up results were analyzed statistically.Results：The main issues included：ventricular septal defect（VSD） patch leakage,right ventricular outflow tract（RVOT） obstruction,tricuspid regurgitation,pulmonary valve regurgitation,right ventricular aneurysm and aortic valve regurgitation.RVOT patch of pericardium mainly led to RVOT aneurysm.Conclusion：It should be concerned that the patients with TOF may need lifelong follow-up and repeated interventions.Advanced surgical techniques,appropriate selection of cardiac incision and material of RVOT patch may reduce the rate of re-operation.And we should deal with the complications earlier.Besides,the treatment strategies of TOF need further clinical studies.

关 键 词：法洛四联症 先天性心脏病 术后并发症 再次手术 

分 类 号：R54[医药卫生—心血管疾病]