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目的 了解法洛四联症 (TOF)根治术后远期心律失常的发生率以及影响心律失常发生的相关因素。方法 54例法洛四联症根治术后患儿 ,男 3 5例 ,女 19例 ;年龄 5～ 14岁 [( 9 4± 2 5)岁 ]。术时年龄 17个月～ 117个月 ,随访年限 2 8～ 9 0年。进行了心电图、2 4小时Holter、二维超声心动图和活动平板运动试验检查。结果 18例患儿存在不同程度的室性心律失常 ,室性心律失常的发生率为 3 3 % ,其中 1例患儿有短阵室性心动过速发生。 4例右室收缩压增高者均存在明显室性心律失常 ,右室收缩压正常者室性心律失常发生率为 2 8% ( 14 / 50例 ) ,两者差异有显著性 (P =0 0 1)。体外循环时间≥ 90min者室性心律失常发生率为 53 % ( 10 / 19例 ) ,体外循环时间 <90min的患儿室性心律失常发生率为 2 3 % ( 8/ 3 5例 ) ,两者差异有显著性 (P <0 0 5)。轻度肺动脉瓣返流组室性心律失常发生率为 2 1% ( 4 / 19例 ) ,中、重度肺动脉瓣返流组室性心律失常的发生率为 40 % ( 14 / 3 5例 ) ,两组差异无显著性 ( χ2 =1 989,P >0 0 5)。随访年限 5年以内室性心律失常发生率为 3 2 % ( 8/ 2 5例 ) ,5年以上患儿的室性心律失常发生率为 3 4 % ( 10 / 2 9例 ) ,两者差异无显著性 ( χ2 =0 0 3 7,P >0 0 5)。手术年龄?
Objective To understand the incidence of long-term arrhythmia and the related factors that affect the occurrence of arrhythmia in patients with tetralogy of Fallot (TOF). Methods 54 cases of tetralogy of Fallot after radical surgery, 35 males and 19 females; aged 5 to 14 years [(9 4 ± 2 5) years old]. The operative age ranged from 17 months to 117 months with a follow-up of 28 to 90 years. Electrocardiography, 24-hour Holter, two-dimensional echocardiography and an active treadmill exercise test were performed. Results 18 cases of children with varying degrees of ventricular arrhythmias, the incidence of ventricular arrhythmia was 33%, of which 1 case of children with paroxysmal ventricular tachycardia occurred. The ventricular systolic pressure increased in 4 patients with obvious ventricular arrhythmia, and the incidence of ventricular arrhythmia in normal right ventricular systolic pressure was 28% (14/50), the difference was significant (P = 0 0 1). The incidence of ventricular arrhythmia was 53% (10/19 cases) in patients with cardiopulmonary bypass time ≥ 90 minutes and 23% (8/3 5 cases) in children with cardiopulmonary bypass time <90 minutes The difference was significant (P <0 05). The incidence of ventricular arrhythmia was 21% (4/19 cases) in mild pulmonary regurgitation group and 40% (14/3 5 cases) in moderate and severe pulmonary regurgitation group, There was no significant difference between the two groups (χ2 = 1 989, P> 0.05). The incidence of ventricular arrhythmia within 5 years of follow-up was 32% (8 of 25 cases), and the incidence of ventricular arrhythmia was 34% (10 of 29 cases) in children over 5 years. No significant (χ2 = 0 0 3 7, P> 0 0 5). Surgery age?