胸腔镜下动脉导管未闭结扎术外科治疗的临床研究

The Clinical Study of Surgical Ligation of Patent Ductus Arterious with Video-Assisted Thoracoscope

目的:总结分析我院近年来实施胸腔镜下动脉导管未闭结扎术16例患者的临床资料,通过探讨胸腔镜下动脉导管未闭结扎术外科治疗的临床研究,从而提供动脉导管未闭外科治疗的适宜方法。方法:手术采用传统常规右侧卧位,胸壁选取适宜胸腔镜插入与操作切口,胸腔镜下分离PDA周围组织结构后,选取尼龙夹夹闭未闭合的动脉导管,术毕安置胸腔引流管,缝合切口,术后及复查时行心脏彩超检查以确定效果。结果:胸腔镜下PDA尼龙夹夹闭术平均手术时间较短,术中及术后出血量较少,心脏杂音消失,心脏彩超提示未闭PDA血流信号消失。结论:胸腔镜下PDA尼龙夹夹闭术较传统开胸PDA结扎术、胸腔镜PDA钛夹钳闭术、介入封堵术效果较好且并发症较少。

Objective：Based on the analysis of clinical operations data and the experience of surgical ligation of Patent Ductus Arterious in 16 patients to provide a suitable method for the people who were the Patent Ductus Arterious.Methods： Patients were positioned on their right lateral and selected the appropriate rick for the thoracoscope and operation.we separated the tissues which were surrounded the Patent Ductus Arterious via video-assisted thoracoscope and occluded it by the nylon clip.Located the intrathoracic drain tube,sutured the incision and reviewed the effect through color Doppler ultrasound after the operation.Results： The surgical ligation of Patent Ductus Arterious.with video-assisted thoracoscope spent less time,the bleeding was less,the cardiac murmur and bridging signal of the PDA was disappeared with the color Doppler ultrasound.Conclusion：It is better for the nylon clip occluding the PDA than the traditional surgery,titanium clip occlusion and the Amplatzer.