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目的探讨经房-肺动脉施行婴幼儿法洛四联症根治术的可行性及早期结果。方法选择青岛市儿童医院2005年3月至2008年6月施行一期法洛四联症(TOF)根治术的145例1～2岁患者,分为经房-肺动脉(96例)和经右心室根治术(49例)2组。比较2组手术中主动脉阻断时间,手术后早期死亡,并发症,呼吸机辅助时间,ICU滞留时间,正性肌力药物应用时间,术后住院时间,应用SAS6.12统计软件对数据进行处理,连续性变量采用t检验,计数变量采用χ2检验。结果术后近期因发生急性呼吸窘迫综合征死亡1例,手术成功率99.3%。经房-肺动脉和经右心室根治术后呼吸机辅助呼吸时间分别为(1.60±1.06)、(4.32±7.86)d,ICU滞留时间分别为(4.59±2.16)、(8.50±10.23)d,应用正性肌力药物时间分别为(7.68±4.26)、(10.89±10.52)d,术后住院时间分别为(12.31±3.60)、(16.52±12.01)d,差异无统计学意义(P>0.05);2组主动脉阻断时间分别为(65.89±6.77)、(75.81±13.41)min,差异有统计学意义(P<0.05)。结论经房-肺动脉施行婴幼儿TOF根治术是可行的,对2岁以下的婴幼儿TOF效果满意。
Objective To investigate the feasibility and early results of radical surgery for tetralogy of Fallot in infants and young children through atrial-pulmonary artery. Methods From March 2005 to June 2008, a total of 145 patients aged 1-2 years undergoing TOF radical mastectomy in Qingdao Children’s Hospital were enrolled in this study. The patients were divided into three groups: atrial-pulmonary artery (96 cases) Ventricular radical surgery (49 cases) 2 groups. The time of aorta occlusion, early death after surgery, complication, ventilator support time, ICU residence time, inotropic drug application time and postoperative hospital stay were compared between the two groups. Data were analyzed using SAS6.12 statistical software Treatment, continuous variables using t test, count variables using χ2 test. Results One patient died of acute respiratory distress syndrome after operation, the success rate was 99.3%. The duration of ventilator assisted breathing after atrial-pulmonary artery and right-ventricular radical operation were (1.60 ± 1.06) and (4.32 ± 7.86) days respectively, and the ICU residence time were (4.59 ± 2.16) and (8.50 ± 10.23) d, respectively The in-duration intima-medications were (7.68 ± 4.26) and (10.89 ± 10.52) days, respectively, and the postoperative hospital stay were (12.31 ± 3.60) and (16.52 ± 12.01) days respectively, with no significant difference (P> 0.05) ; The time of aorta block in the two groups was (65.89 ± 6.77) and (75.81 ± 13.41) min, respectively, the difference was statistically significant (P <0.05). Conclusions Tofacial - pulmonary artery catheterization of TOF is feasible and satisfactory for children under 2 years old.