保瓣手术策略在法洛四联症治疗中的应用进展  

Application of valve-sparing surgery for tetraolgy of Fallot

作　　者：岑宇航 鲁亚南[1] Cen Yuhang;Lu Yanan(Pediatric Heart Center,Affiliated Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院小儿心脏中心,上海200092

出　　处：《临床小儿外科杂志》2025年第2期191-195,共5页Journal of Clinical Pediatric Surgery

摘　　要：法洛四联症(tetralogy of Fallot,TOF)是一种常见的先天性青紫型心脏病,占先天性心脏病的5%~7%。目前手术是TOF的主要治疗方式,大多数患儿经手术治疗后长期预后良好。手术治疗的目的在于解除右心室流出道狭窄,闭合室间隔缺损,尽可能保留肺动脉瓣和维护右心功能。肺动脉瓣反流(pulmonary regurgitation,PR)是TOF根治术后常见并发症,是导致许多不良结局的重要因素。除应用肺动脉瓣置换术治疗术后PR以外,保瓣手术策略逐渐成为TOF治疗的首选手术方式,可以有效预防术后PR的发生或加重,改善患儿预后。本文主要阐述保瓣手术在法洛四联症治疗中的应用进展,包括保瓣手术的应用指征、手术策略、预后以及实施保瓣手术面临的挑战。As a common congenital cyanotic heart disease,tetralogy of Fallot(TOF)accounts for 5%-7%of congenital heart diseases(CHDs).Currently surgery has been a major treatment for TOF and long-term outcomes are satisfactory.The objectives of surgery include relieving stenosis of right ventricular outflow tract,closing ventricular septal defects,preserving pulmonary valve and maintaining right ventricular function as much as possible.Pulmonary regurgitation(PR)is a common complication after TOF surgery and it is an important factor leading to many adverse outcomes.In addition to postoperative PR with pulmonary valve replacement,valve-sparing surgery has gradually become a preferred option for TOF.It can effectively prevent the onset or aggravation of postoperative PR and improve patient outcomes.This review focused upon the indications,strategies,prognoses and challenges of valve-sparing surgery.

关 键 词：法洛四联症 心脏外科手术 方法 手术后并发症 肺动脉瓣闭锁不全 肺动脉瓣 保瓣手术 

分 类 号：R726.5[医药卫生—儿科]