142例婴儿法洛四联症的外科治疗:附5年随访资料
发布时间：2018-07-15 19:04
【摘要】：目的总结外科治疗婴儿法洛四联症(TOF)的临床经验,并对早期、中期疗效进行评价。方法 142例婴儿TOF,术前经心脏彩超和(或)心脏CTA检查确诊,其中男性79例,女性63例;年龄1~12个月,平均(6.4±2.7)个月;体质量3.0~12.0kg,平均(6.7±1.4)kg。McGoon值0.80~2.47,平均1.59±0.34;左室舒张末容积指数14.0~36.3mL/m2,平均(25.5±5.9)mL/m2。138例在中度低温体外循环下行一期根治术,4例行分期根治手术。结果体外循环时间(95.0±21.7)min,主动脉阻闭时间(54.3±15.1)min,术后呼吸机辅助时间(40.2±30.5)h,监护室停留时间(5.0±3.5)d。治愈出院140例,死亡2例(院内死亡率1.4%)。术后二次手术4例(2.8%)。术后并发症主要为低心排出量综合征、肺部感染、急性肾衰竭等,并发症发生率为7.0%(10/142)。随访患儿127例,随访率89.4%,随访时间11~62个月(中位数37个月),均无死亡或再次手术;心功能Ⅰ级117例(92.1%),心功能Ⅱ级10例(7.9%);心脏超声提示右室射血分数(EF)均正常,微量或少量肺动脉瓣反流113例(89.0%),中量反流14例(11.0%),无大量反流。结论婴儿期行TOF根治术是安全有效的,优化手术方法及加强围手术期管理是提高婴儿期TOF手术成功率的关键,术后早期和中期疗效满意。
[Abstract]:Objective to summarize the clinical experience of surgical treatment of tetralogy of Fallot (TOF) in infants and to evaluate the early and intermediate effects. Methods 142 infants (79 males and 63 females) were diagnosed by echocardiography and / or cardiac CTA before operation. The age ranged from 1 to 12 months (mean (6.4 卤2.7) months). The mean body mass was (6.7 卤1.4) kg 路McGoon 0.80 卤2.47, mean 1.59 卤0.34, and left ventricular end-diastolic volume index 14.0 ~ 36.3 mL / m ~ (2), mean (25.5 卤5.9) mL 路m ~ (2) 路m ~ (2.138) cases underwent one stage radical surgery under moderate hypothermia cardiopulmonary bypass. The left ventricular end-diastolic volume index was 14.0 卤36.3 mL / m ~ (2), with an average of (25.5 卤5.9) mL / m ~ (2.138). Results the CPB time was (95.0 卤21.7) min, the aortic occlusion time was (54.3 卤15.1) min, the postoperative ventilator time was (40.2 卤30.5) h, and the stay time was (5.0 卤3.5) days. 140 cases were cured and 2 cases died (hospital mortality 1.4%). 4 cases (2.8%) underwent secondary operation after operation. The main postoperative complications were low cardiac output syndrome, pulmonary infection, acute renal failure, etc. The incidence of complications was 7.0% (10 / 142). 127 cases were followed up, the follow-up rate was 89.4%, the follow-up time was 11 ~ 62 months (median 37 months), no death or reoperation, 117 cases (92.1%) of cardiac function grade 鈪，
本文编号：2125088
[Abstract]:Objective to summarize the clinical experience of surgical treatment of tetralogy of Fallot (TOF) in infants and to evaluate the early and intermediate effects. Methods 142 infants (79 males and 63 females) were diagnosed by echocardiography and / or cardiac CTA before operation. The age ranged from 1 to 12 months (mean (6.4 卤2.7) months). The mean body mass was (6.7 卤1.4) kg 路McGoon 0.80 卤2.47, mean 1.59 卤0.34, and left ventricular end-diastolic volume index 14.0 ~ 36.3 mL / m ~ (2), mean (25.5 卤5.9) mL 路m ~ (2) 路m ~ (2.138) cases underwent one stage radical surgery under moderate hypothermia cardiopulmonary bypass. The left ventricular end-diastolic volume index was 14.0 卤36.3 mL / m ~ (2), with an average of (25.5 卤5.9) mL / m ~ (2.138). Results the CPB time was (95.0 卤21.7) min, the aortic occlusion time was (54.3 卤15.1) min, the postoperative ventilator time was (40.2 卤30.5) h, and the stay time was (5.0 卤3.5) days. 140 cases were cured and 2 cases died (hospital mortality 1.4%). 4 cases (2.8%) underwent secondary operation after operation. The main postoperative complications were low cardiac output syndrome, pulmonary infection, acute renal failure, etc. The incidence of complications was 7.0% (10 / 142). 127 cases were followed up, the follow-up rate was 89.4%, the follow-up time was 11 ~ 62 months (median 37 months), no death or reoperation, 117 cases (92.1%) of cardiac function grade 鈪，
本文编号：2125088
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