摘要
目的:分析影响法洛四联症(TOF)根治术后残余畸形发生的相关因素。方法:回顾性分析我院2013年至2017年,行TOF根治术并有随访资料的200例患者,观察术后近、中期残余畸形的发生情况,包括室间隔残余分流、残余肺动脉狭窄、肺动脉瓣反流。统计分析术后残余畸形的发生与随访时间、手术年龄、手术方式、主动脉骑跨率、右心室流出道内径、室间隔缺损部位、室间隔缺损大小、肺动脉发育等因素的关系。结果:2013至2017年在我院接受TOF根治术患者随访时间3～30个月(中位数24个月)。随着随访时间的延长,室间隔残余分流的发生逐渐减少,残余肺动脉狭窄、肺动脉瓣反流的发生逐渐增加。有轻度及以上肺动脉瓣反流的患者中,行跨瓣环手术占60.9%;无肺动脉瓣反流的患者中,行跨瓣环手术的占30.8%,二者差异有统计学意义(P<0.05)。手术年龄、手术方式、主动脉骑跨率、右心室流出道内径、室间隔缺损部位、室间隔缺损大小、肺动脉发育等情况,在术后近、中期随访中,对室间隔残余分流和残余肺动脉狭窄的发生,差异无统计学意义。结论:全组患者术后无严重残余畸形发生。随着随访时间的延长,室间隔残余分流的发生逐渐减少,残余肺动脉狭窄、肺动脉瓣反流的发生逐渐增加。轻度及以上的肺动脉瓣反流多发生于行跨瓣环手术的患者。
Objective: The aim of this study was to analyze the risk factors influencing the occurrence of residual malformations after total correction of tetralogy of Fallot(TOF). Methods: Clinical data of 200 patients from 2013 to 2017 who received total correction of TOF in our hospital were reviewed. The occurrence of near-and medium-term residual malformations, including ventricular septal residual shunt, residual pulmonary stenosis, and pulmonary valve regurgitation, were observed. The relationship of the occurrence of residual malformations and risk factors, including follow-up time, operation age, operation mode, the rate of aortic ride across, the diameter of right ventricular outflow tract, the position and size of ventricular septal defect, and the development of pulmonary artery, was analyzed. Results: From 2013 to 2017, the follow-up time of patients receiving the total correction of TOF in our hospital was 3-34 months(average 19 months, median 24 months). With the extension of follow-up time, the incidence of ventricular septum residual shunt gradually decreased, and the incidence of the residual pulmonary artery stenosis and pulmonary valve regurgitation gradually increased. In the group of patients with mild or more pulmonary valve regurgitation, 60.9% of patients underwent transvalvular surgery. In the group without pulmonary artery regurgitation, 30.8% of the patients underwent transvalvular surgery. The difference between the two groups was statistically significant(P<0.05). In the near-and medium-term follow-up, the risk factors including operation age, operation mode, the rate of aortic ride across, the diameter of right ventricular outflow tract, the position and size of ventricular septal defect, and the development of pulmonary artery, had little effects on the occurrence of ventricular septal residual shunt and residual pulmonary stenosis. Conclusions: All patients had no serious residual malformations after surgery. With the extension of follow-up time, the incidence of ventricular septum residual
作者
叶文倩
顾燕
丁文虹
吕震宇
李墨琦
马紫君
金梅
YE Wen-qian;GU Yan;DING Wenhong;LV Zhenyu;LI Moqi;MA Zijun;JIN Mei(Center of Congenital Heart Disease,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)
出处
《心肺血管病杂志》
2018年第12期1099-1103,共5页
Journal of Cardiovascular and Pulmonary Diseases
关键词
法洛四联症
残余畸形
相关因素
Tetralogy of Fallot
Residual malformation
Risk factors
