法洛四联症

Tetralogy of Fallot
Tetralogy of Fallot
	正常心臟（左）與法洛四联症患者的心臟
类型	先天性心臟病、發紺性心臟病[]、rare genetic developmental defect during embryogenesis[]、遺傳性疾病、genetic cardiac disease[]、trilogy of Fallot[]、疾病
分类和外部资源
醫學專科	心脏外科、小兒科
ICD-11	LA88.2
ICD-10	Q21.3
ICD-9-CM	745.2
OMIM	187500
DiseasesDB	4660
MedlinePlus	001567
eMedicine	emerg/575
MeSH	D013771
Orphanet	3303
	[编辑此条目的维基数据]

法洛四联症（英語：tetralogy of Fallot，縮寫：TOF^[1]）是由四种心脏及大血管畸形构成的组合性先天性心脏病。这四种畸形是：肺动脉流出道狭窄、室间隔膜部缺损、主动脉右移与骑跨、右心室肥大；为最常见的紫绀型先天性心脏病^[2]。

事实速览 Tetralogy of Fallot, 类型 ...

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法洛四联症出生時的症狀從無症狀到嚴重不等^[3]，之後多半會有發紺（皮膚發藍）的症狀（青紫婴儿）^[4]。當有此症的嬰兒哭泣或排便時，他們可能會有急性缺氧發作：皮膚會轉為藍色，有呼吸困難、跛行、偶爾失去意識（英语：unconsciousness）^[4]。其他症狀可能包含心雜音、杵狀指、吸食母乳時容易疲勞^[4]。

法洛四联症的病因目前還不清楚^[5]。風險因素包括懷孕時使用酒精，或是孕婦患有糖尿病、年齡超過40歲或懷孕期間患上德國麻疹^[5]^[6]，它也可能與唐氏症候群有關^[5]。一般會有四種缺陷^[2]：

肺動脈狹窄（英语：pulmonary stenosis）：是右心室出口狹窄。
心室中隔缺損：左右心室之間有一個破洞。
右心室肥大：右心室肌肉增厚。
主動脈跨位：是兩個心室中的血液皆可進入主動脈。

法洛氏四重症通常於一歲時進行開心手術^[7]，手術的時間取決於嬰兒的症狀與體型^[7]，過程涵蓋增加肺動脈瓣（英语：pulmonary valve）和肺動脈的大小並修復心室中膈缺損^[7]。若是嬰兒年紀太小，可先進行暫時性的手術並安排於較大時進行二次手術^[7]。大多數有此症的患者皆能存活至成年^[2]。目前法洛氏四重症的治療效果良好，30年生存率為68.5%至90.5%之間[1] （页面存档备份，存于互联网档案馆）。長期的問題可能包含心律不整以及肺動脈瓣閉鎖不全（英语：pulmonary regurgitation）^[8]。

每兩千名新生兒中就有一例出現法洛氏四重症^[2]，男嬰女嬰罹患機率相等^[2]為最常見的複雜性先天性心臟病，約佔複雜性先天性心臟病的10%^[9]^[10]，1671年時，尼古拉斯·斯坦諾第一次提到了法洛氏四重症^[11]^[12]。1888年時由法國醫生艾蒂安-路易·亞瑟·法洛（英语：Étienne-Louis Arthur Fallot）做更進一步的描述，並因此得名^[11]^[13]。於1954年，進行第一次的修復手術^[8]。

[1]
Q. Ashton Acton. Tetralogy of Fallot: New Insights for the Healthcare Professional. ScholarlyEditions. 2013. ISBN 9781481656146.
[2]
What Is Tetralogy of Fallot?. NHLBI. 1 July 2011 [2 October 2016]. （原始内容存档于4 October 2016）.
[3]
Hay, William W.; Levin, Myron J.; Deterding, Robin R.; Abzug, Mark J. Current diagnosis & treatment : pediatrics Twenty-third. New York, NY. 2016-05-02. ISBN 9780071848541. OCLC 951067614.
[4]
What Are the Signs and Symptoms of Tetralogy of Fallot?. NHLBI. 1 July 2011 [2 October 2016]. （原始内容存档于5 October 2016）.
[5]
What Causes Tetralogy of Fallot?. NHLBI. 1 July 2011 [2 October 2016]. （原始内容存档于5 October 2016）.
[6]
Pregnancy and congenital heart disease. Roos-Hesselink, Jolien W., Johnson, Mark R. Cham: Springer. 2017: 62. ISBN 9783319389134. OCLC 969644876.
[7]
How Is Tetralogy of Fallot Treated?. NHLBI. July 1, 2011 [2 October 2016]. （原始内容存档于5 October 2016）.
[8]
Warnes, Carole A. The Adult With Congenital Heart Disease. Journal of the American College of Cardiology. July 2005, 46 (1): 1–8. PMID 15992627. doi:10.1016/j.jacc.2005.02.083.
[9]
Yuh, David D. Johns Hopkins textbook of cardiothoracic surgery 2nd. New York: McGraw-Hill Companies. 2014. ISBN 9780071663502. OCLC 828334087.
[10]
Types of Congenital Heart Defects. NHLBI. 1 July 2011 [2 October 2016]. （原始内容存档于5 October 2016）.
[11]
Fallot's tetralogy. Whonamedit?. [2 October 2016]. （原始内容存档于3 October 2016）.
[12]
Van Praagh, R. The first Stella van Praagh memorial lecture: the history and anatomy of tetralogy of Fallot.. Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual. 2009, 12: 19–38. PMID 19349011. doi:10.1053/j.pcsu.2009.01.004.
[13]
Fallot, Arthur. Contribution à l'anatomie pathologique de la maladie bleue (cyanose cardiaque), par le Dr. A. Fallot, .... Marseille: Impr. de Barlatier-Feissat. 1888: 77–93. OCLC 457786038 （法语）.

van der Ven, J. P. G., van den Bosch, E., Bogers, A. J. C. C., & Helbing, W. A. (2019). Current outcomes and treatment of tetralogy of Fallot. F1000Research, 8, F1000 Faculty Rev-1530. https://doi.org/10.12688/f1000research.17174.1

参考书目

《医学卫生普及全书》上海科技出版社，上海第一医学院编，统一书号：141191543

What Is Tetralogy of Fallot? （页面存档备份，存于互联网档案馆） at National Institute of Health
Understanding your child’s heart: Tetralogy of Fallot; by the British Heart Foundation British Heart FoundationBritish Heart FoundationBritish Heart FoundationBritish Heart Foundation （页面存档备份，存于互联网档案馆）
Interactive 3-D Animation of Tetralogy of Fallot Repair - Stanford Children's Health （页面存档备份，存于互联网档案馆）

[1] [1]
Q. Ashton Acton. Tetralogy of Fallot: New Insights for the Healthcare Professional. ScholarlyEditions. 2013. ISBN 9781481656146.

[NIH2011What-2] [2]
What Is Tetralogy of Fallot?. NHLBI. 1 July 2011 [2 October 2016]. （原始内容存档于4 October 2016）.

[Curr2016-3] [3]
Hay, William W.; Levin, Myron J.; Deterding, Robin R.; Abzug, Mark J. Current diagnosis & treatment : pediatrics Twenty-third. New York, NY. 2016-05-02. ISBN 9780071848541. OCLC 951067614.

[NIH2011Sym-4] [4]
What Are the Signs and Symptoms of Tetralogy of Fallot?. NHLBI. 1 July 2011 [2 October 2016]. （原始内容存档于5 October 2016）.

[NIH2011Ca-5] [5]
What Causes Tetralogy of Fallot?. NHLBI. 1 July 2011 [2 October 2016]. （原始内容存档于5 October 2016）.

[6] [6]
Pregnancy and congenital heart disease. Roos-Hesselink, Jolien W., Johnson, Mark R. Cham: Springer. 2017: 62. ISBN 9783319389134. OCLC 969644876.

[NIH2011Tx-7] [7]
How Is Tetralogy of Fallot Treated?. NHLBI. July 1, 2011 [2 October 2016]. （原始内容存档于5 October 2016）.

[War2005-8] [8]
Warnes, Carole A. The Adult With Congenital Heart Disease. Journal of the American College of Cardiology. July 2005, 46 (1): 1–8. PMID 15992627. doi:10.1016/j.jacc.2005.02.083.

[9] [9]
Yuh, David D. Johns Hopkins textbook of cardiothoracic surgery 2nd. New York: McGraw-Hill Companies. 2014. ISBN 9780071663502. OCLC 828334087.

[10] [10]
Types of Congenital Heart Defects. NHLBI. 1 July 2011 [2 October 2016]. （原始内容存档于5 October 2016）.

[Name2016-11] [11]
Fallot's tetralogy. Whonamedit?. [2 October 2016]. （原始内容存档于3 October 2016）.

[VanP2009-12] [12]
Van Praagh, R. The first Stella van Praagh memorial lecture: the history and anatomy of tetralogy of Fallot.. Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual. 2009, 12: 19–38. PMID 19349011. doi:10.1053/j.pcsu.2009.01.004.

[Fallot1888-13] [13]
Fallot, Arthur. Contribution à l'anatomie pathologique de la maladie bleue (cyanose cardiaque), par le Dr. A. Fallot, .... Marseille: Impr. de Barlatier-Feissat. 1888: 77–93. OCLC 457786038 （法语）.

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参考书目

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法洛四联症

参考书目

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病因及診斷

治療及預後

流行病學及歷史

参见

参考文献

外部連結