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1992年12月至1994年5月,共为175例5个月至5岁的患儿在深低温、低流量体外循环下行法乐四联症根治术,平均年龄2.99±1.49岁;平均体重11.90±2.84(7~19)kg。其中61例(34。7%)跨肺动脉瓣环补片加宽右室流出道,其中53例至左右肺动脉分叉处或左肺动脉起始部,5例应用液氮保存的同种带瓣升主动脉(4例取自新生儿,1例取自成人),手术证实71例(43.0%)并发其它畸形。手术死亡2例,死亡率1.1%。死亡原因为灌注肺及心包填塞各1例。我院在本组病例手术期间,凡确诊法乐四联症患儿均予手术根治,手术指征有进一步放宽趋势,手术死亡率却明显降低,这与畸形纠正满意,注意围术期的心、肺保护以及加强术后处理有关。
From December 1992 to May 1994, a total of 175 children aged 5 months to 5 years underwent radical tetrandrine radical operation under deep hypothermia and low-flow cardiopulmonary bypass with an average age of 2.99 ± 1.49 years ; Average body weight 11.90 ± 2.84 (7 ~ 19) kg. Among them, 61 cases (34.7%) had widening of right ventricular outflow tract through the pulmonary valve, among them, 53 cases had left or right pulmonary artery bifurcation or left pulmonary artery, and 5 cases were treated with liquid nitrogen Aorta (4 from neonates and 1 from adults) confirmed 71 cases (43.0%) with other abnormalities. Surgery in 2 cases, the mortality rate of 1.1%. The cause of death was perfusion of lung and pericardial packing in 1 case. In our hospital during the operation of this group, all children with confirmed tetralogy of Fallot were undergoing radical operation. The indications for operation were further relaxed and the operative mortality rate was significantly reduced. This was satisfactory with deformity correction, and attention should be paid to the perioperative heart , Lung protection and enhanced postoperative management.