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目的总结法乐氏四联症根治术后低心排的预防及治疗方法。方法2003年1月至2006年5月共进行法乐氏四联症根治术468例。其中2月至2岁95例,3岁至12岁267例,13岁至28岁106例。肺动脉指数(Nakata指数)为(153.47±0.3)mm2/m2,左室容积指数(36.82±15.73)m l/m2,M cGoon比值1.5±0.3。均在全麻低温体外循环下行根治术。结果术后发生低心排27例,低心排发生率为5.77%,死亡3例,低心排死亡率为11.11%。结论法乐氏四联症根治术后低心排的防治重点在于重视术前处理及病情评估,术中心肌保护及右室流出道疏通,术后胶体容量补充及强心治疗。
Objective To summarize the prevention and treatment of low cardiac output after the treatment of tetralogy of Fallot. Methods From January 2003 to May 2006, 468 cases of tetralogy of Fallot were undergone. Among them, 95 cases were from February to 2 years old, 267 cases were from 3 to 12 years old and 106 cases were from 13 to 28 years old. The pulmonary artery index (Nakata index) was (153.47 ± 0.3) mm2 / m2, the left ventricular volume index (36.82 ± 15.73) m1 / m2, M cGoon ratio 1.5 ± 0.3. In general anesthesia hypothermia cardiopulmonary bypass radical surgery. Results Postoperative low cardiac output in 27 cases, low cardiac output was 5.77%, 3 died, low cardiac death rate was 11.11%. Conclusion The prevention and treatment of tetralogy of Fallot after radical surgery is focused on preoperative management and assessment of disease, intraoperative myocardial protection and right ventricular outflow tract dilatation, postoperative colloid volume and cardiac therapy.