论文部分内容阅读
目的探讨一期外科手术治疗婴儿期法洛四联症(TOF)的经验。方法 2002年1月-2010年2月本科共收治TOF患儿77例。男46例,女31例;年龄2～12个月[(9.06±2.72)个月];体质量3.5～10.0 kg[(5.98±0.96)kg]。≤6个月组28例,7～12个月组49例,均行TOF一期根治术,其中10例术前有缺氧发作而行亚急诊手术治疗。比较不同年龄组围术期处理方法、手术死亡率、并发症及随访结果。结果 TOF77例中,术后死亡3例(3.89%),均死于术后低心排综合征,其余均治愈出院。≤6个月与7～12个月婴儿TOF比较,术后低心排综合征发生率较高(χ2=6.45,P<0.05),且前者应用肾上腺素、葡萄糖酸钙的使用率较高(χ2=13.67、19.96,Pa<0.05),呼吸机辅助时间、ICU停留时间及住院时间较长(t=2.254、2.297、2.631,Pa<0.05)。术后随访6个月～5 a,无远期死亡,患儿生长发育均良好。结论 <6个月婴儿TOF可以早期施行一期外科纠治,近期效果满意,而远期效果良好。
Objective To investigate the experience of one-stage surgical treatment of tetralogy of Fallot (TOF) in infancy. Methods From January 2002 to February 2010, 77 undergraduate children were enrolled in TOF. There were 46 males and 31 females, ranging in age from 2 to 12 months [(9.06 ± 2.72) months]; body mass 3.5 to 10.0 kg [(5.98 ± 0.96) kg]. 28 cases of ≤6 months, 49 cases of 7 ~ 12 months, all underwent radical one-stage TOF, including 10 cases of hypoxic preoperative hypothyroidism surgery. Perioperative management of different age groups, operative mortality, complications and follow-up results were compared. Results In TOF77 cases, 3 cases died of postoperative death (3.89%), all died of postoperative low cardiac output syndrome, and the rest were cured and discharged. The incidence of postoperative low cardiac output syndrome (χ2 = 6.45, P <0.05) was lower in ≤6 months and 7 ~ 12 months old infants, and the former had higher use of adrenaline and calcium gluconate χ2 = 13.67, 19.96, Pa <0.05). The ventilator assisted time, ICU stay time and hospital stay were longer (t = 2.254,2.297,2.631, Pa <0.05). All the patients were followed up for 6 months to 5 years without any long-term death. The children’s growth and development were good. Conclusion TOF in infants younger than 6 months can be surgically treated one stage early, with satisfactory results in the near future and good long-term results.