左听诊三角与左胸后外侧切口下动脉导管未闭缝扎术的比较  

Comparative study of patent ductus arteriosus surgical ligation between ausculatry triangle thoracotomy and posterolateral thoracomoty

作　　者：艾斯卡尔.沙比提 乔峻[1] 木拉提[1] 马松峰[1] 霍强[1] 

机构地区：[1]新疆医科大学第一附属医院心血管外科

出　　处：《中国心血管病研究》2006年第10期752-753,共2页Chinese Journal of Cardiovascular Research

摘　　要：目的评估左听诊三角切口(ATT)与后外侧切口(PLT)下动脉导管未闭(PDA)缝扎术的疗效。方法随机分为研究组(ATT)和对照组(PLT)。两组患者性别、年龄无明显差异。ATT组58例,自第4后肋与脊柱之间中点始,跨听诊三角区,绕过肩胛骨下缘1～2cm的弧形皮肤切口,经第4肋间切开肋间肌,行胸膜外PDA缝扎术;PLT组58例,标准后外侧切口,经肋床或肋间进胸行PDA缝扎术。结果ATT组术后渗血少,无二次开胸病例;PLT组术后渗血多,需二次开胸3例。两组均无手术死亡病例。ATT组平均切口长度、开胸、关胸及手术操作时间较PLT组短(P<0.01);术后引流量、住院天数ATT组较PLT组少(P<0.05),差异有统计学意义。结论采用ATT行动脉导管未闭缝扎术,出血少,切口小,瘢痕隐蔽,疼痛轻,恢复快,适用于婴幼儿、儿童、体形瘦小及胸壁肌肉瘦薄的成年患者。Objective To compare the curative effect of PDA surgical ligation between left Ausculatry triangle thoracotomy （ATT） and Posterolateral incision （PLT）. Methods 58 operations were divided into 2 groups： ATT group and PLT group. ATT group cut skin from the middle point of the fourth posterior rib and vertebral column acrossed the left ausculatry triangle area, to 1-2 centimeters below inferior margin of left ornoplata and formed a arc incision and then cut the intercostals muscle. Finish the transfixion out of the pleura. The PLT group adopted the posterolateral incision. Enter into the thoracic cavity from the intercostals and finish the PDA transfixion. Results No dead patient in two goups. There are obvious statistical differences between two groups in length of incision, operation time, hospital day, amount of drainage and ATT group is superior to PLT group. Conclusion There are many advantagements in Ausculatry triangle thoracotomy PDA transfixion that little memoriam, smaller incision, little pain, recover faster and contradict to infant, child, and the thin adult patients.

关 键 词：动脉导管未闭缝扎术 左听诊三角切口 左后外侧切口 

分 类 号：R654.2[医药卫生—外科学]