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目的探讨婴幼儿法络四联症一期手术根治的经验。方法回顾性分析一期手术根治的146例婴幼儿法络四联症患儿的临床资料。146例婴幼儿法络四联症患儿术前均行超声心动图检查明确室缺大小,主动脉骑跨和肺动脉狭窄程度。常规中度低温体外循环下施行矫治手术。术后常规监护>48 h,辅助呼吸10 h~3 d,出院时复查胸片、心电图及心脏彩超等。结果术后严重低心输出量综合征(低心排)死亡5例,灌注肺死亡3例,右心衰竭死亡1例,术后并发严重心律紊乱死亡1例,余无明显肝肾功能损害和神经系统并发症,无完全性房室传导阻滞。随访6~48个月,无远期死亡,心功能达Ⅰ~Ⅱ级,生长发育良好。结论一期根治术是治疗婴幼儿法络四联症安全有效的方法。
Objective To explore the experience of the first stage operation of infantile tetralogy of Fallot. Methods The clinical data of 146 children with infantile tetralogy of Fallot (TP) who underwent radical surgery were retrospectively analyzed. 146 cases of Infantile tetralogy of Fallot children underwent echocardiography before surgery to clear the size of atrial septum, aortic riding and pulmonary stenosis. Conventional moderate hypothermia under cardiopulmonary bypass operation. Postoperative routine monitoring> 48 h, assisted breathing 10 h ~ 3 d, discharged from the chest X-ray examination, ECG and cardiac ultrasonography. Results After the operation, 5 patients died of severe low cardiac output syndrome (low cardiac output), 3 died of perfusion of the lung, 1 died of right heart failure, 1 died of severe heart rhythm after operation, Nervous system complications, no complete atrioventricular block. All the patients were followed up for 6 ~ 48 months without any long-term death. Their heart functions reached grade Ⅰ ~ Ⅱ and their growth was good. Conclusions A radical operation is a safe and effective method for the treatment of tetralogy of Fallot.