动脉导管未闭疑合并畸形采用胸骨正中切口手术的报告  

Midline Sternotomy Aproroach for Operation on Patent Ductus Arteriosus Suspicious of Intracardiac Lesions

作　　者：张殿堂[1] 张代文[1] 张荣华[1] 殷桂林[1] 胡建才[1] 朱水波[1] 张晓明[1] 庞大志[1] 

机构地区：[1]广州军区武汉总医院心胸外科

出　　处：《中国胸心血管外科临床杂志》1996年第3期142-143,共2页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：对５４例ＰＤＡ合并或疑合并畸形者采用胸骨正中切口手术，术前常规备体外循环（ＣＰＢ）。术前１４例疑合并心内畸形者中４例证实合并心内畸形，在ＣＰＢ下进行了心内畸形修复。３例术前合并重度肺动脉高压，术中发现ＰＤＡ形状异常，在ＣＰＢ下经肺动脉切口作了ＰＤＡ内口缝合。另１例ＰＤＡ重度肺动脉高压分离时破裂大出血，即在ＣＰＢ下切断缝合挽救了患者生命。采用仰卧位胸骨正中切口，术前备ＣＰＢ，有利术中合并畸形处理及手术安全。In this paper,the authors report the surgical treatment in 54 patients with PDA suspicious of intracardiac anomalies,in which the midline sternotomy approach was selected while the apparatus for cardiopulmonary bypass was standby in all cases.As result,in 14 cases preoperatively suspicious of other cardiac anomalies,4 were confirmed to have other cardiac lesions through extracardiac or intracardiac exploration,which were repaired simultaneously on prepared CPB;large and abnormal PDA in 3 patients with severe pulmonary hypertension was closed through the pulmonary arteries on CPB;one patient with a large PDA was almost exsanguinated because of severe bleeding from rupture of PDA when it was divided but was salvaged successfully with the prepared CPB.The authors consider that midline sternotomy with standly CPB is beneficial to the manage of associated cardiac lesions and a safer procedure.

关 键 词：动脉导管未闭 心内畸形 胸骨正中切口 外科手术 

分 类 号：R654.2[医药卫生—外科学]