摘要
目的:总结分析单中心11年法乐四联症患儿围术期结果及变化趋势。方法:选择自2009年1月至2019年12月因法乐四联症就诊于我院首次行外科手术治疗的患儿。研究分析患儿病变特征、手术方法的选择、围术期结果及变化趋势。结果:共入选法乐四联症患儿3952例,其中男性2410例,中位年龄11.52(7.56,22.80)个月,身高74(68,84)cm,体重9(7.7,11.4)kg。行一期根治术的患儿为3818例(96.61%),选择分期根治患儿98例(2.48%),姑息手术患儿36例(0.91%)。围术期死亡患儿共36例,死亡率为0.91%,延迟恢复(重症监护病房时间>14天)的患儿为65例(1.64%)。根治术患儿采用非跨环补片比例从46.48%上升至50.88%,年患儿总数从446例下降至230例,患儿年龄从14.64个月下降至9.84个月。为明确患儿年龄下降是否影响围术期结果,将近5年结果与前6年结果进行比较发现:择期手术的患儿年龄下降后,死亡率、延迟恢复比例无增加,术后重症监护病房时间未延长,术后补救性侧支封堵比例下降。结论:法乐四联症患儿手术治疗围术期并发症发生率低,效果良好。本中心患儿数量逐年减少,非跨环根治手术比例上升,择期手术年龄下降。尽早手术治疗能使更多患儿获益。
Objectives:To analyze the perioperative results and trends of patients with tetralogy of Fallot during 2009 to 2019.Methods:From January 2009 to December 2019,patients with tetralogy of Fallot,who underwent first surgical treatment in our hospital,were enrolled.The characteristics of patients'pathological changes,selection of surgical methods,perioperative results and trends were analyzed.Results:A total of 3952 patients were enrolled,2410 were male,aged 11.52(7.56,22.80)months,height was 74(68,84)cm,and weight was 9(7.7,11.4)kg.3818 patients(96.61%)underwent primary repair,98 patients(2.48%)underwent staged repair and 36 patients(0.91%)underwent palliative operation.36 patients died in perioperative period,and the mortality rate was 0.91%.65 patients(1.64%)had delayed recovery(Intensive Care Unit/ICU time was more than 14 days).The proportion of the patients who underwent non-transannular patch repair increased from 46.48%to 50.88%.The total number of patients decreased from 446 to 230 per year,and the age of patients decreased from 14.64 to 9.84 months.Despite decreased age at surgery,the death rate and delayed recovery rate did not increase,the length of ICU stay did not extend,and the rate of remedial collateral occlusion decreased.Conclusions:The incidence of perioperative complications of tetralogy of Fallot is low.The number of patients decreased,the proportion of non-transannular patch repair increased,and the age at operation decreased,and patients can benefit significantly from the early surgical treatment.
作者
龚丁旭
张本青
林野
马凯
刘锐
闫军
花中东
胡盛寿
李守军
GONG Dingxu;ZHANG Benqing;LIN Ye;MA Kai;LIU Rui;YAN Jun;HUA Zhongdong;HU Shengshou;LI Shoujun(Department of Pediatric Cardiac Surgery,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),China)
出处
《中国循环杂志》
CSCD
北大核心
2021年第5期470-474,共5页
Chinese Circulation Journal
基金
国家重点研发计划资助项目(2017YFC1308100)
国家自然科学基金青年科学基金项目(81700282)
协和青年基金资助和中央高校基本科研业务费专项资金资助项目(3332018195)。
关键词
法乐四联症
围术期结果
变化趋势
外科治疗
tetralogy of Fallot
perioperative results
trends
surgical treatment
