胸骨左缘第二肋间切口微创治疗动脉导管未闭31例

The minimally invasive treatment for patent ductus arteriosus via the second intercostal incision on the left margin of sternum approach:31 cases

目的评估经胸骨左缘第二肋间切口微创治疗动脉导管未闭的临床疗效和可靠性。方法收集2014年1月—2017年11月我科对31例婴儿期患儿行动脉导管结扎术的临床资料,所有手术均采用经胸骨左缘第二肋间切口入路,总结该术式的手术过程,分析其临床转归。结果本组病例手术过程顺利,手术切口长度(2.5±1.0)cm,手术时间(1.5±0.2)h,术中出血不超过5 m L,术后平均住院日(15.1±4.2)d,未出现死亡、大出血等重大并发症,术后无需放置胸腔引流管。术后随访1个月~4年,无导管再通及动脉瘤形成。结论胸骨左缘第二肋间切口微创治疗动脉导管未闭是一种安全可靠的方法,并发症少,远期疗效满意。

Objective To evaluate the clinical efficacy and reliability of the minimally invasive treatment of patentductus arteriosus（PDA） via the second intercostal incision on the left margin of sternum.Methods Clinical data of 31 infantile children undergoing ligation of PDA in Tianjin First Center Hospital from January 2014 to November 2017 werecollected.All cases were performed operation through the second intercostal incision on the left margin of sternum.Theoperative process of this operation was summarized,and its clinical outcome was analyzed.Results The operation wentsmoothly,the length of the incision was（2.5±1.0） cm,the operation time was（1.5±0.2） h,the intraoperative bleeding was lessthan 5 m L,and the average length of hospital stay was（15.1±4.2） d.There were no complications such as death and massivehemorrhage in the perioperative period.The thoracic drainage tube was not needed after the operation.During the follow-upfrom 1 month to 4 years,catheter recanalization and aneurysm formation were undetected.Conclusion The treatment ofPDA with the second intercostal incision on the left margin of sternum is safe and reliable.It has fewer complications andbetter long-term effect.