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目的：总结连续１１５ 例小儿法乐四联症根治术无手术死亡经验。方法：１１５ 例法乐四联症病儿，９ 月龄～１３ 岁，平均（４ ．６ ±２ ．７） 岁，３ 岁以下５５ 例，合并有肺总动脉或一侧肺动脉闭锁４ 例，肺动脉瓣缺如１ 例，合并房间隔缺损和动脉导管未闭１１ 例。全部病儿均施行根治手术，用ｄａｃｒｏｎ 补片修补室间隔缺损，用自体心包作右室流出道及肺动脉扩大，１０２ 例（８９ ％ ） 作了跨瓣环补片。结果：全组无手术死亡。随访２ ～４８ 个月，术后３ 个月１ 例死于心律紊乱，其余均恢复良好。结论：提高小儿法乐四联症根治术成功率的关键是：改进手术方法，彻底解除右室流出道及肺动脉远端梗阻，选用适当的转流技术和重视术后监测。
Objective: To summarize the experience of 115 cases of tetralogy of Fallot without surgery. Methods: One hundred and fifteen children with tetralogy of Fallot were aged from 9 months to 13 years old (average, 4.6 ± 2.7) years old and under 3 years old, with 4 cases of pulmonary common artery or pulmonary atresia, Pulmonary valve defect in 1 case, with atrial septal defect and patent ductus arteriosus in 11 cases. All patients were undergone radical surgery, with dacron patch ventricular septal defect repair, with the pericardial right ventricular outflow tract and pulmonary artery enlargement, 102 cases (89%) made of transvalvular patch. Results: All patients died without surgery. A follow-up of 2 to 48 months, 1 patient died of arrhythmia 3 months after surgery, the rest were good. Conclusion: The key to improve the success rate of tetradication in children with tetralogy of Fallot is to improve the surgical approach to completely relieve the right ventricular outflow tract and pulmonary distal obstruction, the appropriate choice of bypass technology and emphasis on postoperative monitoring.