2种术式一期根治法洛四联症中期效果对比分析  

Comparative analysis of mid-term therapeutic effects of two kinds of one-stage radical treatment of tetralogy of Fallot

作　　者：宋海龙 张会军[1] SONG Hai-long;ZHANG Hui-jun(Department of Cardiac Surgery,the First Hospital of Hebei Medical University,Shijiazhuang 050031,China)

机构地区：[1]河北医科大学第一医院心脏外科,河北石家庄050031

出　　处：《河北医科大学学报》2023年第8期905-909,914,共6页Journal of Hebei Medical University

基　　金：河北省医学科学研究课题计划(20220716)。

摘　　要：目的比较2种术式一期根治法洛四联症术后中期手术效果。方法回顾性分析行法洛四联症一期根治术患儿101例。根据右心室流出道狭窄的解除方式分为肺动脉瓣跨环补片联合自体心包制作肺动脉单瓣组(A组,49例)和单纯肺动脉瓣跨环补片组(B组,52例)。比较2组患儿行一期根治术后及术后5年的临床效果。结果一期根治术后,A组呼吸机辅助呼吸时间及监护室时间均短于B组,肺动脉瓣反流程度优于B组(P<0.05)。术后随访5年,2组术后生存率和手术再干预率差异无统计学意义(P>0.05)。结论法洛四联症一期根治行肺动脉瓣跨环补片联合自体心包制作人工肺动脉单瓣,在缩短呼吸机辅助时间及监护室时间方面效果优于单纯跨环补片,但术后5年生存率及手术再干预率差异无统计学意义(P>0.05)。Objective To compare the mid-term surgical effects of the two kinds of one-stage radical treatment of tetralogy of Fallot.Methods A retrospective analysis was performed on 101 patients with tetralogy of Fallot.According to the way of right ventricular outflow tract stenosis,the patients were divided into pulmonary valve transannular patch combined with autologous pericardium to make a single pulmonary artery valve group(group A,n=49)and simple trans-annular pulmonary artery patch group(group B,n=52).The clinical effects after one-stage radical treatment and at 5 years after surgery were compared between two groups.Results After one-stage radical treatment,the duration of ventilator assistance and length of intensive care unit(ICU)stay in group A were shorter than those in group B,and the degree of pulmonary valve regurgitation was better than that in group B(P<0.05).At 5 years after follow-up,there were no significant differences in postoperative survival rate and surgical reintervention rate between two groups(P>0.05).Conclusion One-stage radical treatment of tetralogy of Fallot with pulmonary valve transannular patch combined with autologous pericardium to make a single artificial pulmonary artery valve is better than that with transannular patch in shortening the duration of ventilator assistance and length of ICU stay,but there are no statistically significant differences in the 5-year survival rates after surgery and surgical re-intervention rates of the two groups.

关 键 词：法洛四联症 跨环补片 人工肺动脉瓣 

分 类 号：R654.25[医药卫生—外科学]