低温循环暂停经肺动脉闭合重症未闭动脉导管101例报告

Closure of severe patent ducts arterious via pulmonary artery using hypothermal circulatory temporary arrest flow

目的 :探讨重症动脉导管未闭 (PDA)在低温循环暂停下经肺动脉闭合的临床意义和体外转流技巧。方法 :对 1986～ 1999年接受低温循环暂停经肺动脉闭合的 10 1例重症PDA进行回顾性分析。手术时循环暂停时间平均为 7min48s(2min2 9s～ 13min 38s)。结果 :97例 (96 .0 4% )效果满意。早期死亡 4例 ,均为合并的心内畸形复杂、术后重度低排、多器官功能衰竭所致 ,无其它与直接灌注有关的合并症。结论 :低温循环暂停经肺动脉闭合PDA的方法简便、安全、术野清晰 ,是适用于PDA合并复杂情况的转流方法。

Objective:To probe into the clinical significance and method of extra-transflow of hypothermal circulatory temporary arrest flow(HCTAF) in the closure of severe patent ducts arterious(PDA) via pulmonary artery.Methods:Since 1986 to 1999,101 cases of severe PDA with or without other complex heart diseases were operated upon by this method.HCTAF was used in an average time of 7 min48 s(2 min29 s to 13 min38 s).Results:97 cases(96.04%) gained satisfactory results.4 cases died at the early postoperative period owing to complicated very complex heart malformations,postoperative severe low blood drainage and multiple organ failures.No other complications directly related to perfusion was found.Conclusion:This procedure is a safe and simple operative method.Using this method,the operative field is clear.It is a suitable transflow method for the operation in patients with severe PDA complicated with other complex situations.