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目的研究8kg以下小体重法乐氏四联症(F4)患儿的围手术期治疗措施,以及其对提高术后治愈率的影响,以指导今后的工作。方法对1995年8月—2010年8月,在全麻、低温、体外循环下行手术治疗的96例体质量<8kg的F4病例进行分析研究。其中男性52例,女性44例,年龄30d～3岁。全组96例患儿采用气管插管、静脉复合麻醉、低温体外循环并经主动脉根部灌注晶体停跳液。采用胸部正中切口。全组患儿均采用主动脉、右房上、下腔插管建立体外循环,全部患儿在阻断前常规建立左心引流。结果早期死亡2例,占2.2%。随访94例,采用来院复查方式。随访时间:术后3个月～13年,随访至13年时有49例得到随访复查,45例失访。随访到患儿均能正常生活,心功能Ⅰ级,右室流出道通畅,无残余分流。结论小体重量F4在围手术期整体管理对于手术成功率具有重大意义。
Objective To study the perioperative treatment of children with small weight tetralogy of Fallot (F4) weighing less than 8kg and its influence on improving the cure rate after operation to guide the future work. Methods From August 1995 to August 2010, 96 cases of F4 cases with body mass less than 8kg under general anesthesia, hypothermia and cardiopulmonary bypass were analyzed. Among them, 52 males and 44 females were aged from 30 days to 3 years old. The whole group of 96 children with tracheal intubation, intravenous anesthesia, hypothermic cardiopulmonary bypass and perfusion through the aortic root of the crystalloid cardioplegia. Using the chest incision. All children were using aorta, right atrium, inferior lumen intubation to establish cardiopulmonary bypass, all children routinely establish left ventricular drainage before occlusion. Results Early death in 2 cases, accounting for 2.2%. Follow-up 94 cases, used to review the way. Follow-up time: 3 months to 13 years after operation, 49 cases were followed up for follow-up to 13 years and 45 cases were lost to follow-up. Follow up to children with normal life, cardiac function grade Ⅰ, right ventricular outflow tract patency, no residual shunt. Conclusion Body weight F4 in the overall perioperative management for the success rate of surgery is of great significance.