摘要
本院外科在近三年内收治36个月以下婴幼儿法乐氏四联症108例。年龄25.0±9.4个月,体重10.1±2.0kg。所有患儿术前符合法乐氏四联症的诊断。在低温体外循环下施行法乐氏四联症根治术。经积极有效的手术治疗和术后早期处理,治愈97例,治愈率89.8%,早期死亡11例,死亡率10.2%。本文讨论了影响外科治疗效果的因素和治疗体会。
One hundred and eight (68 males and 40 females, aged 25.0±9.4 months with a range of 5-36) infants with tetralogy of Fallot underwent repair between January 1988 and December 1990. Body weight was 10.1±2.0 kg, among them 60.1% (65 cases) were below 10 kg. Characteristic physical sign, hematological, angiocardiographic and echocardiographic features of tetralogy of Fallot were observed in all patients. The angiocardiographic results in 89 cusses showed that the positions of ventricular septal defect (VSD) were subaortic (n=76), and subpulmonary (n=6). 15 cases had severe right ventricular outflow tract (RVOT) stenosis. 52 infants of mild to medium RVOT stenosis were associated with pulmonary valvular nad annular stenosis. 20 patients had diffused right ventricular infundibular hypoplasia plus left and right pulmonary artery hypoplasia. 2 of these patients were associated with patent ductus arteriosus and 5 with atrial septal defect. The degrees of aortic overriding onto the right ventricle were 35-75%. All infants were operated on through a right ventriculotomy under eardiopulmonary bypass. RVOT patch was performed in 66 patients (62.3%), transannular patch of the pulmonary artery was needed in 40 patients (37.7%). Cardiopulmonary bypass time was 92.4±1.8 min and circulation arrest time was 57.7±16.1 min. Postoperative intensive care including respirator-assisted respiration (15.6±18.1 hours), dopamine 6.4±3.7μg/kg/min (n=80), digoxin 0.21±0.10 mg (n=88) was administrated to all patients in the first 24 hours after Operation, Acute respiratory or circulatory insufficieney occurred in 32 patients following operation. Early hospital death was 10.2%.
出处
《中国循环杂志》
CSCD
1993年第4期213-215,共3页
Chinese Circulation Journal
关键词
法乐氏四联症
心脏外科手术
Infancy, Tetralogy of Fallot, Surgical treatment
