动脉导管未闭的外科治疗  

Surgical treatment of patent ductus arterious

作　　者：韩培立[1] 席鸿钧[1] 王忠民[1] 李汉臣[1] 刘建伟[1] 杨宏伟[1] 

机构地区：[1]新乡医学院一附院

出　　处：《新乡医学院学报》1996年第2期122-124,共3页Journal of Xinxiang Medical University

摘　　要：目的探讨动脉导管未闻（ＰＤＡ）的手术治疗及其效果．方法ＰＤＡ患者８９例，单纯管型分别行双重结扎加贯穿缝孔（５４例），主动脉外膜下结扎（１８例）．单纯双重结扎（４例），心包内结扎（１例）和切断缝合（１例）．其余１１例在体外循环下切开肺动尽缝合导管内口。结果死亡１例（１．１２％）。术后杂音完全消失者８２例（９２．１３％）心尖区有轻度收缩期杂音２例（２．２５％），肺动脉井区有ＳＭⅡ～Ⅲ／６者４例（４．４９％）术后血压升高２２例．其中１例出现高血压脑病．６８例随访６ｍｏ～５ａ，未发现导管再通．结论双重结扎加贯穿缝扎治疗ＰＤＡ安全可靠，疗效满意．ＰＤＡ术后应重视高血压的防治．Objective To research for the operative method and therapeutic effect of patent ductus arterious (PDA). Methods Eighty-nine patients with PDA were observed. The patients with simple tubular form (78cases) were treated by double ligation and transfixion (54cases), ligation under adventitia of aorta (18cases), simple double ligation (4 cases), intrapericardial ligation(1cases)and excision suture (1 cases) .Theother 11 patients were treated by excision of pulmonary artery and the internal opening of duct was sewn up under extra-corporeal circulation. Results one case (1. 12% ) of PDA was dead in 89 patientS treated by operation. The murmur disappeared complately after operation in 82 cases (92.13%) There was slight systolic murmur apical region of heart in 2 cases (2.25% ),and SMⅡ-Ⅲ / 6 in pulmonary area in 4 cases (4.49%) .There were 42 cases of elevation of blood pressure after operation, but 41 cases recovery after treatffient, and one case appeared hypertensive encephalopathy that recoveried after emergency treatment.The reopening duct arterious hadn. t been found in following up foral 6 month to 5 year. Conclusions The double ligation combining with transfixion for PDA is safe and reliable,and the therapeutic effect is satisfactory. It should be paid attention to the prevention and treatttient of hypertension after operatio n.

关 键 词：动脉导管未闭 外科手术 并发症 高血压 

分 类 号：R654.305[医药卫生—外科学]