摘要目的 归纳总结法洛四联症(TOF)根治术中采取保留肺动脉瓣双孔成形法的临床经验及其疗效.方法 回顾性总结分析53例保留肺动脉瓣双孔成形TOF根治术患者(观察组)临床资料,并与同期常规TOF根治术患者50例(对照组)比较.结果 两组患者年龄、体重等一般情况相似,术中体外循环转流时间、主动脉阻断时间差异无统计学意义(P＞0.05),术后呼吸机辅助通气时间差异无统计学意义(P＞0.05),观察组术后ICU滞留时间短于对照组(P＜0.05);观察组42例术后无胸腔积液、8例少量、1例中量、2例大量胸腔积液,对照组27例术后无胸腔积液、17例少量胸腔积液、5例中量胸腔积液、1例大量胸腔积液;术后一周复查均无肺动脉瓣狭窄,观察组无肺动脉返流30例、轻度返流15例、中度8例,对照组无肺动脉返流14例、轻度返流16例、中度17例、重度3例;术后半年观察组复查33例,均无重度肺动脉返流、仅轻中度返流3例;术后1年观察组复查18例,无肺动脉瓣返流.结论 采用保留肺动脉瓣双孔成形法处理肺动脉瓣狭窄简便易行,可减轻肺动脉瓣返流、减少术后胸腔积液等并发症,改善早期外科预后.

abstractsObjective To introduce a new technique to create a pulmonary valve biorifice for reconstruction of right ventricular outflow tract in tetralogy of Fallot (TOF),and to summarize its initial clinical experience and therapeutic effect.Methods The new technique regarding reconstruction of right ventricular outflow tract with a pulmonary valve biorifice was used in a total of 53 TOF cases (the observation group).The conventional technique regarding reconstruction of right ventricular outflow tract was used in other 50 TOF cases (the control group).The clinical dates of all cases were reviewed retrospectively.Results The ages,weights,cardiopulmonary bypass time,cardiac arrest time,as well as the post operation ventilation support time were not different significantly between two groups.Compared with the contrul group,patients from the observation group had shorter duration of ICU stay.After operation,in the observation group,only 2 cases had large amount of pleural effusion,1 case meddle,and 8 cases little amount of pleural effusion; whereas,in the control group,the corresponding numbers were 1,5 and 17,respectively.At the time point of 1 week after operation,all patients were rechecked by echocardiography,no pulmonary valve stenosis was found.Moderate pulmonary valve regurgitation was found in 8 cases,mild regurgitation in 15 cases from the observation group; and severe regurgitation in 3 cases,moderate regurgitation in 17 cases,and mild regurgitation in 16 cases from the control group.A total of 33 cases from the observation group were rechecked at the time point of half year after operation,and moderate - mild pulmonary regurgitation were found in 3 cases.A total of 18 cases of them were rechecked 1 - year latter,no pulmonary regurgitation was found.Conclusions The new technique to create pulmonary valve biorifice can reduce the pulmonary valve regurgitation and postoperative pleural effusion,and improve the early outcomc.