Tof全矫正手术后痰沫患者死亡率增高

Suprayitno Wardoyo, Dhama Shinta Susanti, Aflah Dhea Bariz Yasta, R. Agustian, Laksana Paduan Wilangsoka
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引用次数: 0

摘要

法洛四联症(TOF)是最常见的先天性心脏病。TOF最常见的危险因素是唐氏综合症(DS)。TOF有两种治疗方法:药物治疗和手术治疗。手术/外科治疗包括姑息性分流和最终修复。部分TOF患者出现侧支或主主动脉-肺动脉侧支(MAPCAs),可在手术完成后引发肺溢流。这导致CPB在修复操作中的时间较长,从而导致CPB机缺血使用导致RV/LV功能障碍的风险非常高。痰沫是左、右心室功能不全所致肺损伤的征象之一,可增加TOF修复患者的死亡率。本研究的目的是确定痰沫与TOF修复患者死亡率的关系。本研究为横断面研究。我们通过2019 - 2020年病案清单回顾性收集数据。本研究纳入32例患者资料,男性(n = 22)多于女性(n = 10)。发现TOF修复术后7例女性患者,9例男性患者出现痰沫。死亡率(p值为0.033)和痰沫与肺反流(p值为0.049)均有相关性。虽然本研究的任何结果和前文所述的不足,但本研究可以作为进一步研究的基础,为TOF修复患者的痰沫处理制定合适的指南。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Increased Mortality Rate in Patient with Frothy Sputum After Tof Total Correction Surgery
Tetralogy of Fallot (TOF) is the most common congenital heart disease. The most common risk factor for TOF is Down syndrome(DS). There are two management approaches for TOF: medication and operation. Operation/surgical treatment is consisted of palliative shunt and definitive repair. In several case patients with TOF develop collaterals or major aortopulmonary collateral arteries (MAPCAs), which can lung overflow can be initiated after surgery procedure was completed. This causes the CPB time in the repair operation to be long so that the risk of RV/LV dysfunction due to ischemic use of the CPB machine is very high. Frothy sputum is the one of signs of lung injury that related to left and/or right ventricular dysfunction, it may increased mortality in patients TOF repaired. The aim of this study was to identify frothy sputum associated with mortality in patient repaired of TOF. This study is cross-sectional study. We collect data retrospectively through medical record list from 2019 to 2020.  In our study, there were 32 patients data included, consisted with more dominant male (n = 22) compare to female (n = 10). It was found that 7 female patients and 9 male patients experienced frothy sputum after TOF repair surgery. There are association not only mortality (p-value 0.033) but also frothy sputum with pulmonary regurgitation (p-value 0.049). Although any result of the study and weakness described previously, the study can be as basis for futher research so that an appropiate guideline can be established to deal frothy sputum in patients TOF repaired. 
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