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目的探讨婴幼儿法洛四联症的矫治手术时机、心肺保护及术后并发症的防治。方法选择161例法洛四联症婴幼儿施行手术治疗,男91例,女70例,年龄4～36个月,平均(18±6)个月;体重5.0～15.5kg,平均(10.3±2.1)kg。一期根治156例,Green分流4例,B-T分流1例。结果术后早期死亡6例,病死率3.7%(6/161),术后并发症为低心排出量综合征、呼吸衰竭、急性肾衰竭、脑损害和血管渗透综合征。低心排出量综合征和呼吸衰竭是手术早期死亡的主要原因。结论婴幼儿法洛四联症根治手术效果良好,联合超滤可明显减轻肺损害,腹膜透析治疗血管渗透综合征可取得较好疗效。
Objective To investigate the timing of operation, cardiopulmonary protection and postoperative complications prevention and treatment of tetralogy of Fallot in infants and young children. Methods A total of 161 infants with tetralogy of Fallot were enrolled in this study. There were 91 males and 70 females aged from 4 to 36 months (average, 18 ± 6 months), weighing 5.0-15.5 kg (mean, 10.3 ± 2.1) ) kg. A radical cure in 156 cases, Green shunt in 4 cases, B-T shunt in 1 case. Results Six patients died early after operation, with a mortality rate of 3.7% (6/161). Postoperative complications included low cardiac output syndrome, respiratory failure, acute renal failure, brain damage and vascular permeability syndrome. Low cardiac output syndrome and respiratory failure are the leading causes of early death. Conclusion Tetralogy of Fallot in infants and young children with good effect of radical surgery, combined with ultrafiltration can significantly reduce lung damage peritoneal dialysis treatment of vascular permeability syndrome can achieve better results.