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目的总结婴幼儿法洛四联症(TOF)根治术的治疗经验,探讨手术时机、手术及术后处理方法。方法 2004年1月-2009年12月本科共完成婴幼儿TOF根治术65例。男39例,女26例;年龄5.5个月～3.0岁;体质量5～16kg[(9.0±1.5)kg]。患儿术前均行超声心动图或心导管造影检查确诊。全部经右心室流出道切口完成疏通,有巨大体肺侧支的5例患儿在根治术前行侧支血管堵塞术。结果本组围术期死亡3例(3.1%),其中2例死于低心排综合征,1例死于呼吸衰竭。余62例手术均获得成功。出院后随访1～84个月,除3例发现VSD残余分流、1例偶发室性期前收缩外,余患儿均无异常。结论婴幼儿期行TOF根治术可获得满意的临床效果。提高技术水平、加强术后监护是确保手术成功的关键。
Objective To summarize the experience of treatment of tetralogy of Fallot (TOF) in infants and young children, and discuss the timing of operation, operation and postoperative management. Methods January 2004 - December 2009 undergraduate completed a total of 65 cases of infants TOF radical mastectomy. 39 males and 26 females; aged 5.5 months to 3.0 years; body weight 5 ~ 16kg [(9.0 ± 1.5) kg]. Children with preoperative echocardiography or cardiac catheterization confirmed. All through the right ventricular outflow tract incision to clear, with huge pulmonary collateral 5 cases of children in the radical mastectomy collateral vessel occlusion. Results The perioperative deaths occurred in 3 cases (3.1%), of which 2 died of low cardiac output syndrome and 1 died of respiratory failure. 62 cases of surgery were successful. All patients were followed up for 1 to 84 months after discharge. Except for 3 cases of VSD residual shunt and 1 case of incident ventricular premature contractions, no abnormality was found in the remaining children. Conclusion TOF in infants and young children can achieve satisfactory clinical results. Improve the technical level and strengthen the postoperative care is the key to ensure the success of the operation.