左腋下微切口Hem-O-lok夹与传统左后外侧切口治疗动脉导管未闭的比较研究

Comparative study between the left armpit minimal invasive thoracotomy with Hem-O-lok clip and traditional left posterolateral thoracotomy in treatment of patent ductus arteriosus

目的:比较左腋下微切口Hem-O-lok夹,与传统左后外侧切口治疗动脉导管未闭的临床结果。方法:回顾2000年03月至2014年03月间,我院对69例小龄儿动脉导管未闭分别采用左腋下微切口Hem-O-lok结扎夹治疗(微创组37例)和传统左后外侧切口治疗(传统组32例),对比两组术中出血量,手术时间,术后拔胸腔引流管时间,胸腔引流量,术后住院日及术后第二日对患儿予口诉言语评分法(VRS)结合其哭闹程度的疼痛评分并进行总结。结果:两组患者均无死亡、大出血等重大并发症,在术中出血量,手术时间,术后拔胸腔引流管时间,胸腔引流量,术后住院日及术后第二日对患儿予VRS结合其哭闹程度疼痛评分,微创组均优于传统组,差异有统计学意义(P<0.05)。结论:左腋下微切口Hem-O-lok结扎夹治疗动脉导管未闭是一种安全可靠的方法,具有微创、美观、恢复快等优点。

Objective： To compare the outcome between the left armpit minimal invasive thoracotomy with Hem-O-lok clip and traditional left posterolateral thoracotomy in treatment of patent ductus arteriosus（ PDA）. Methods： Retrospective analysis 69 cases of young children with PDA from March 2000 to March2014. The patients were divided into two groups. In minimally invasive group（ 37 cases）,left armpit minimal thoracotomy was deployed by using Hem-O-lok ligating clip. In traditional group（ 32 cases）,the traditional left posterolateral thoracotomy was deployed. Intraoperative blood loss,Operation time,removal of chest tube drainage time,discharge time and the pain scores（ verbal rating scales combined with children crying degree at the second day after surgery） were compared in these two groups. Results： Every contents in minimally invasive group were better than that of traditional group,and the differences were statistically significant（ P〈0.05）.Conclusion： Using Hem-O-lok ligating clip in left armpit minimal invasive thoracotomy is a kind of safe,reliable,artistic and fast recovery method for patients with patent ductus arterious.