正中切口体外循环下处理动脉导管未闭100例

目的探讨正中切口体外循环(CPB)下处理动脉导管未闭(PDA)的外科治疗方法。方法回顾性分析本院1993年10月至2005年2月正中切口下处理100例PDA的临床特点、手术方式及其转归。结果术后除右心功能不全2例及术后早期出现声音嘶哑3例外,无其他重大并发症发生,均痊愈出院。结论各种心内畸形经常合并PDA,术前诊断及术中探查,意义重大;严格掌握手术指征和提高CPB技术,对降低手术死亡率及术后并发症具有重要意义;经肺动脉切口缝闭PDA是CPB下处理PDA的主要方法,术中应用Foley导尿管阻断动脉导管血流,有利于术野显露、缩短CPB时间,可降低肺部、脑部并发症。

Objective To evaluate the surgical techniques for patent duetus artefiosus （PDA） . Methods A retrospect was made on the 100 cases of PDA treated with surgical treatment of median incision and cardiopulmonary bypass , clinical features、 surgical management and results were analyzed . Results Except for 2 patients who had right heart insufficiency and 3 patients who had hoarse voice, there were no severe complications in the others patients and they were discharged with a good recovery. Condusion PDA was often combined with all kinds of intracardial malformation ,prcoperational diagnosis and interoperative exploration are extremely helpful for diagnosis. A strict control of indication and the improvement of CPB technique are significant to lower the death rate and postoperative complication . Suturing PDA through incision in pulmonary artery under CPB is the main treatment for PDA, using Foley catheter to block arterial canal flow helps to fully expose the operating field ,shorten CPB duration and lower the complications of lungs and brain .