成人法洛氏四联症的外科治疗

【摘要】 目的 总结成人法洛氏四联症的外科治疗经验。方法自1999年6月至2009[1]年6月我们共收治了161例14周岁以上的法洛氏四联症患者,均在全麻低温体外循环下进行了外科手术治疗。其中153例行法四根治术,8例行姑息手术。结果 全组死亡4例,死亡率2.48%。死于低心排2

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【摘要】 目的 总结成人法洛氏四联症的外科治疗经验。方法自1999年6月至2009[1]年6月我们共收治了161例14周岁以上的法洛氏四联症患者,均在全麻低温体外循环下进行了外科手术治疗。其中153例行法四根治术,8例行姑息手术。结果 全组死亡4例,死亡率2.48%。死于低心排2例,术后灌注肺1例,急性肾功能衰竭1例,二次气管插管13例(8.07%),2例术后复查心脏彩超发现室缺残余瘘。无再次开胸止血。随访139例,6个月~93个月,无远期死亡。结论成人法洛氏四联症病情复杂,外科手术治疗并发症发生率偏高,但注意在术前改善症状,术中满意矫治心脏畸形和术后积极防治并发症,远期疗效良好。

【Abstract】 Objective To summarize surgical treatment of adult tetralogy of Fallot and experience.Methods we have

treated 161 patients(the age over 14)with tetralogy of Fallot

from June 1999 to June 2009.They underwent cardiac surgery with

hypothermic cardiopulmonary bypass and general anesthesia. 153 received radical correction of tetralogy of Fallot, 8 patients received palliative surgery. Results There were 4 deaths, the mortality rate was 2.48%. 2 patients died of low cardiac output, 1 pulmonary edema, 1 case of acute renal failure. 13 cases secondary tracheal intubation (8.07%), 2 postoperative echocardiography review found that the residual fistula. No re-thoracotomy to stop bleeding. Follow-up of 139 cases from 6 months to 93 months, no long-term death. Conclusion The adult tetralogy of Fallot is a complex disease, surgical treatment have high incidence of complications, but improve the symptoms of preoperative, corrected heart malformations Satisfactory in operation and postoperative treated complication positive, long-term efficacy is very good.


[1]. 330008,江西省南昌市,南昌大学第三附属医院心胸外科

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