This article has discussed TOF, its occurrence, physiology, medical interventions and nursing implications. In its classic form, TOF consists of four anatomical aberrations: a large VSD, pulmonic stenosis, dextroposition of the aorta, and right ventricular hypertrophy. Surgical palliation versus primary intracardiac repair is a continuing discussion in medical literature. Children who have undergone intracardiac repair for TOF have an excellent prognosis for late survival, near 90% 10 years after repair. Nursing responsibilities in the care of the newborn diagnosed as having TOF encompass the well-being of the newborn as well as the family. Palliation increases pulmonary arterial flow, thus decreasing cyanosis and promoting measurable clinical improvement in the infant. Preparation of the family and child for surgery involves completing a baseline assessment of family dynamics, diagnosing stressors, composing objectives, carrying out interventions focused on developmental ability, and evaluating the effectiveness of the nursing process. Maintaining the physical and emotional integrity of a child just out of the operating room is a challenge. Parental support is important to the young child's feelings of security while hospitalized.
本文讨论了法洛四联症(TOF),包括其发病情况、生理学、医学干预措施及护理要点。典型的法洛四联症由四种解剖结构异常组成:大型室间隔缺损、肺动脉狭窄、主动脉右位及右心室肥厚。手术姑息治疗与一期心内修复在医学文献中一直是讨论的话题。接受法洛四联症心内修复手术的患儿远期生存预后良好,修复术后10年生存率接近90%。对诊断为法洛四联症的新生儿进行护理,责任涵盖新生儿及其家庭的福祉。姑息治疗可增加肺血流量,从而减轻发绀症状并促进婴儿在临床上的可测量改善。为家庭和患儿进行手术准备包括完成家庭动态的基线评估、诊断压力源、制定目标、实施针对发育能力的干预措施以及评估护理过程的有效性。维持刚做完手术的患儿的身体和情感完整性是一项挑战。住院期间,父母的支持对幼儿的安全感很重要。