左腋下小切口手术治疗动脉导管未闭45例
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摘要
目的 探讨左腋下小切口治疗动脉导管未闭的价值。方法左腋中线纵行小直切口第三肋间进胸腔，切开纵隔胸膜，游离动脉导管，绕过三道丝线，逐一结扎闭合导管。结果 采用该法治疗动脉导管未闭会45例，无手术死亡，无再通病例，术中导管破例1例成功闭合，合并主动脉缩窄1例同期纠治成功。并发左下肺不张、左胸腔积液各1例，治愈。结论 此法创伤小，术后恢复快，美观，显露满意，适用于小儿、成人、合并肺动脉高压、合并主动脉弓降部畸形等病例。
[Objective] To evaluate the value of left sub-axilla mini-incision surgical treatment of patent ductus arteriosus(PDA). [Methods] Left vertical mini-incision along midaxillary line,opended thoracic cavity through the third intercostal space,incited mediastinal pleura ,detached PDA,then go three silks around the PDA and ligation one by one to close the ductus.
[Results] The methods were used in 45 cases continuously,no death directly related to the surgical procedure,no recanarization was found.one ductus disruption during operating was closed successfully.one ductus combined with coarctation was successfully corrected.complication includedrleft inferior pulmonary atelectasis,left pleural effusion,lease respectively.
[Conclusion] The injury derived from the methods was limited,and recover quickly postopration,and good cosmetic effect.the methods are suitable to childrensN adults ^ combined with pulmonary hypertentio^ combined with other malformation in aortic arch or descending aorta.
[Objective] To evaluate the value of left sub-axilla mini-incision surgical treatment of patent ductus arteriosus(PDA). [Methods] Left vertical mini-incision along midaxillary line,opended thoracic cavity through the third intercostal space,incited mediastinal pleura ,detached PDA,then go three silks around the PDA and ligation one by one to close the ductus.
[Results] The methods were used in 45 cases continuously,no death directly related to the surgical procedure,no recanarization was found.one ductus disruption during operating was closed successfully.one ductus combined with coarctation was successfully corrected.complication includedrleft inferior pulmonary atelectasis,left pleural effusion,lease respectively.
[Conclusion] The injury derived from the methods was limited,and recover quickly postopration,and good cosmetic effect.the methods are suitable to childrensN adults ^ combined with pulmonary hypertentio^ combined with other malformation in aortic arch or descending aorta.
引文
1 Moore R, Freedon R M. Minimally invasive repair of atriol spptal deferts, Ann Thorac surg, 1998,65: 765-767.
2 陈满荫，何建行，揭运有，等．改良胸后外侧小切口与传统开胸手术的肺功能对比．中华胸心血管外科杂志，2000，16：326
3 李树森，陈晓慨，龙明生，等．婴幼儿动脉导管未闭的外科治疗．中华胸心血管外科杂志，1999，15：33
4 朱小东，主译，先天性心脏病外科学．北京：人民卫生出版社，1996．244-248．
5 Castane AR. Cardiac surgery of the neonate and infant. Philadephia: W.B. Saunders Company, 1994.207.
2 陈满荫，何建行，揭运有，等．改良胸后外侧小切口与传统开胸手术的肺功能对比．中华胸心血管外科杂志，2000，16：326
3 李树森，陈晓慨，龙明生，等．婴幼儿动脉导管未闭的外科治疗．中华胸心血管外科杂志，1999，15：33
4 朱小东，主译，先天性心脏病外科学．北京：人民卫生出版社，1996．244-248．
5 Castane AR. Cardiac surgery of the neonate and infant. Philadephia: W.B. Saunders Company, 1994.207.