Szydłowski Lesław, Marek-Szydłowska Teresa, Rudziński Andrzej, Pajak Jacek, Morka Jacek, Stołtny Ludwik
Klinika Kardiologii Dzieciecej, Slaska Akademia Medyczna w Katowicach.
Przegl Lek. 2004;61(6):650-2.
Tetralogy of Fallot (TOF) coexisting with atrioventricular canal septal defect (AVC) is a rare combination of anomalies. Additionally, in cases with concomitant Down syndrome, recurrent infections can be a serious problem in patients (pts.) waiting for cardiosurgery treatment. The purpose of the study was an analysis of types of infections and other factors complicating the preoperative period in those patients.
The study group consisted of 17 pts. with TOF and AVC aged from 1 day to 9 years (mean 9.4 month). In this group there were 11 pts. with Down syndrome. All of them were subjected to physical examinations, blood analysis, ECG, chest X-ray and echocardiographic study. Additionally, in 8 pts. we performed catheterization. The signs of different types of infection were analyzed and results were compared in two groups: with and without Down syndrome.
The differences were observed in the frequency of recurrent or chronic infections (21 v/s 4), time of hospitalization before surgery (17 v/s 9 days), necessity (11 v/s 3) and duration of antibiotic therapy (19 v/s 7 days) in the two studied groups. Elevated body temperature of unknown etiology was noted in 8 cases with Down syndrome, compared to 1 patient without trisomy 21. Also, the children with Down syndrome had to wait 11 days longer (19 v/s 8) for discharge after operation.
Infections in children with TOF, AVC and Down syndrome significantly complicate the natural course of this anomaly. Prolonged preoperation time is characteristic of Down syndrome pts. compared to patients without chromosomal abnormalities.
法洛四联症（TOF）合并房室通道间隔缺损（AVC）是一种罕见的异常组合。此外，对于合并唐氏综合征的病例，反复感染可能是等待心脏外科治疗的患者面临的严重问题。本研究的目的是分析这些患者术前感染的类型以及其他使病情复杂化的因素。
研究组由17例年龄从1天至9岁（平均9.4个月）的TOF合并AVC患者组成。该组中有11例患有唐氏综合征。所有患者均接受了体格检查、血液分析、心电图、胸部X线和超声心动图检查。此外，8例患者进行了心导管检查。分析了不同类型感染的体征，并在有和没有唐氏综合征的两组中比较了结果。
在反复或慢性感染的频率（21比4）、术前住院时间（17比9天）、抗生素治疗的必要性（11比3）和持续时间（19比7天）方面，两组之间存在差异。8例唐氏综合征患者出现了病因不明的体温升高，而无21三体综合征的患者仅有1例。此外，唐氏综合征患儿术后出院等待时间要长11天（19比8）。
TOF、AVC合并唐氏综合征患儿的感染显著使这种异常的自然病程复杂化。与无染色体异常的患者相比，术前时间延长是唐氏综合征患者的特征。
