18例成人法洛四联症矫治术经验总结及效果评价(1)
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【摘要】 目的 本文旨在探讨成人法洛四联症矫治术的经验及本院18例成人法洛四联症矫治术后效果。方法 2001~2008年间18例法洛四联症患者,手术时平均年龄(22.5±3)岁,纽约心脏学会心功能分级12例为Ⅱ级,6例为Ⅲ级。本组所有患者中11例患者施行了跨肺动脉瓣环补片,余7例患者实施了右室流出道补片。术后随访时间(35±22)月,定期复查彩色超声心动图、心电图了解患者心功能情况及生存质量。结果 院内死亡1例,死于术后多器官功能衰竭,死亡率5.6%,远期死亡1例,死于感染性心内膜炎。3例患者随访中出现肺动脉瓣中等量返流,13例患者随访中心功能明显改善,生存质量显著提高。结论 成人法洛四联症矫治术可达到比较满意的效果,跨肺动脉瓣环补片对远期心脏功能恢复无明显影响。
【关键词】法洛四联症;成人患者;肺动脉瓣;心脏功能
18 adult patients with tetralogy of Fallot correction surgery and evaluation Experience
LIU Wei.
cardiovascular surgical department of Shangqiu first People’s Hospital 476000,China
【Abstract】 Objective This article aims to explore the adult tetralogy of Fallot correction surgery experience and on our 18 adult patients with tetralogy of Fallot after correction of results.Methods From 2001 to 2008 years,18 cases of tetralogy of Fallot patients,patients with an average age of (22.5±3) years old,New York Heart Association cardiac functional class grade Ⅱ,12 cases,6 cases of grade Ⅲ.All patients in this group of 11 cases underwent pulmonary valve ring cross patch,I implemented the 7 patients with right ventricular outflow tract patch were followed up for (35±22) months,regularly review the color Doppler echocardiography,ECG and heart function in patients understand the quality of life.Results The hospital mortality 1,died of multiple organ failure after surgery,mortality rate 5.6%,1 late death,died of infective endocarditis.Follow-up occurred in 3 cases moderate pulmonary valve regurgitation,13 patients were followed up center function improved quality of life improved significantly.Conclusion The correction of tetralogy of Fallot surgery can achieve more satisfactory results,cross-pulmonary valve ring patch on long-term cardiac function is observed.
【Key words】Tetralogy of Fallot; Adult patients; Pulmonary heart valve;Cardiac function
DOI:10.3760/cma.j.issn 1673-8799.2010.06.07
作者单位:476000河南省商丘市第一人民医院心血管外科
法洛四联症是最为常见的紫绀型心脏病,尽管随着医学的发展、外科技术的进步,大多数法洛四联症患者在早期被发现并予以治疗,但仍然有一部分成年法洛四联症患者需要外科处理,尤其是在经济相对落后的地区[1]。由于长期的缺氧导致脑部并发症、心脏功能减退以及室性心律失常的易发,对成人法洛四联症患者的处理仍然是考验外科医师的重要问题[2]。
笔者对8年间在我院行法洛四联症矫治术的成年患者进行长期随访,监测患者心脏功能及心电图的变化,尤其是右室功能的变化,并且评价患者术后生存质量,现将研究结果报告如下 ......
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