89例成人法洛四联症经外科手术治疗的远期疗效汇总分析  

Analysis about the long-term efficacy of the surgical treatment for the adult tetralogy of Fallot 89 cases

作　　者：方恒晓[1] 杨柳山[1] 张赋[1] 吴文森[1] 江毅[1] 范悦[1] 蒙裕国[1] 钟炜祥[1] 

机构地区：[1]广西中医药大学附属瑞康医院胸心外科,广西南宁530001

出　　处：《现代仪器与医疗》2014年第3期56-59,共4页Modern Instruments & Medical Treatment

摘　　要：目的 :考察外科手术治疗法洛四联症的远期临床疗效,为该类疾病的外科治疗提供临床参考。方法:以我院2008年3月至2013年7月间收治的89例法洛四联症患者为研究对象,评价项目包括患者术后死亡率、并发症发生情况及心脏功能改善等。结果 :术后近期疗效评价结果显示,4例患者于术后30d内死亡,死亡原因为多器官功能衰竭和低心排血量综合征。并发症的总发生率为40.44%,其中以低心排血量综合征(6.74%)、胸腔积液(7.87%)、灌注肺(6.74%)为高发并发症。远期疗效显示,患者生存率为94.38%(84/89),NYHA心脏功能分级1级患者73例(73/84,11.90%),2级患者11例(11/84,13.09%)。整体而言,外科手术治疗TOF的近期和远期临床效均较好。结论:术前充分评价患者的心肺功能及合并畸形,可有效提高手术疗效、降低并发症发生率,个体化的外科治疗方案可使成人型TOF患者获得良好的临床疗效。Objective：To investigate the long-term clinical efifcacy of the surgical treatment for the patients with tetralogy of Fallot, expected to provide a clinical reference for the surgical treatment of such diseases.Methods：89 cases patients with the tetralogy of Fallot were the objects for this study, which were treated in our hospital during 2008.03 to 2013.07, to evaluate the short and long-term effect of the surgical treatment for the patients with tetralogy of Fallot. The events of evaluation were the postoperative mortality, the occurrence of complications and the cardiac function improvement. Results：The results of short term effect showed 4 patients were died within postoperative 30 days, and the cause of death were the multiple organ failure and low cardiac output syndrome. The overall incidence of complications was 40.44%, and the low cardiac output syndrome （6.74%）, the pleural effusion （7.87%） and the perfusion lung （6.74%） with a high incidence of complications. The results of long term effect showed the patients survival rate was 94.38% （84/89）, the patients with NYHA heart functional class 1 was 73 cases （ 73/ 84, 11.90% ） and 11 cases with NYHA heart functional class 2 （ 11/ 84, 13.09% ）. Overall, the short-term and long-term clinical effect of the surgical treatment for adult TOF were good.Conclusions：Based on the lesion characteristics of adult TOF patients, preoperative evaluation of cardiorespiratory function and malformations, could effectively improve the clinical efifcacy and reduce the incidence of complications of TOF patients, individualized surgical treatment can received a good efifcacy for adult TOF patients.

关 键 词：法洛四联症 外科治疗 远期疗效 

分 类 号：R541.1[医药卫生—心血管疾病]