动脉导管未闭的外科治疗

Surgical treatment for patent ductus arteriosus(PDA)

目的 探讨动脉导管未闭合理手术方式。方法 总结外科治疗动脉导管未闭 117例 ,其中合并肺动脉高压 42例 ,合并心血管病变 34例。经左后外侧切口结扎 6 9例 ,切断缝合 14例 ,经正中切口结扎 5例 ,体外循环下修补 2 9例。结果 手术死亡 1例 ,远期死亡 1例 ,喉返神经损伤 2例 ,无导管再通。结论 根据年龄 ,导管类型、粗细 ,合并肺动脉高压及心血管病变选择合适的手术方式 ,并严格掌握手术适应证 。

Objective To study the proper choice of the operative methods for PDA.Methods The surgical treatments for 117 patients with PDA were reviewed,of which,42 cases accompanied with pulmonary hypertension,34 with intracardiac malformation.Via the left posterolateral incision,69 cases were performed by ligation,14 by division and suture.Via the median sternal incision, 5 cases were performed by ligation and 29 cases were repaired under extracorporeal circulation.Results No case showed recurrence of PDA after surgical management.One died during the operation,another case died of heart failure one year later.Two cases were complicated with the injury of the recurrent laryngeal nerve.Conclusions We suggest that the determination of surgical treatment for PDA should depend on the age of patient,the type and size of PDA,the accompaniment of PDA with pulmonary hypertension or intracardiac malformation. [