婴儿及新生儿动脉导管未闭急诊手术治疗26例分析  

Analysis of small infant and neonatal emergency surgical treatment of patent ductus arteriosus （ report of 26 cases）.

作　　者：阳广贤[1] 曾德斌[1] 刘剑[1] 易立文[1] 王敬华[1] 刘平波[1] 

机构地区：[1]湖南省儿童医院心胸外科,湖南省长沙市410007

出　　处：《临床小儿外科杂志》2013年第4期289-292,共4页Journal of Clinical Pediatric Surgery

摘　　要：目的探讨婴儿期重症动脉导管未闭的急诊手术治疗经验。方法回顾性分析2007年9月至2012年8月我们收治的26例婴儿及新生儿动脉导管未闭患儿临床资料，其中新生儿12例，包括早产儿10例，足月新生儿2例，术前需呼吸机辅助通气者12例；婴儿14例，术前需呼吸机辅助通气6例。均行急诊动脉导管未闭手术治疗，15例经左腋下横切口，10例经左腋下直切口进行动脉导管结扎术。结果26例均顺利完成手术，1例术中出现动脉导管破裂，予直接缝合；术后复查无残余分流，无并发症。26例随访2～72个月，生长发育良好，心功能正常，无导管再通及假性动脉瘤形成。结论婴儿及新生儿粗大动脉导管未闭需及时手术治疗，以阻断异常分流，减少肺血，纠正心衰，及时关闭动脉导管，能有效缩短重症监护时间，降低死亡率。．Objetive To explore the emergency surgical experience in the small infant and neonate who with intensive patent ductus arteriosus （PDA）. Methods The clinical data of 26 cases beside surgical ligation of PDA from September 2007 to August 2012 were restrospectively analyzed, there are 12 neonates who includ- ed ~0 premature neonates and two term neonates, all they required mechanical ventilation preoperatively. There are 14 infants included 6 infants who needed mechanical ventilation preoperatively. We operated with left transaxillary transverse incision in 15 cases and left transaxillary straight incision in 10 cases. Results 26 ca- ses were operated successfully completed, Arterial catheter ruptured intraoperatively in one case which be di- rectly sutured, no residual shunt postoperatively and surgical complication occured. 26 patients were followed up from 2 to 72 months who with good growth and development and normal heart function, no catheter recanali- zation and pseudoaneurysm occured. Conclusion. Infant and neonate intensive PDA should be surgical treated timely which can block the abnormal shunt and reduced pulmonary blood and correct heart failure, the timely surgical treatment can also effectiveiy shorten the time in the intensive care and reduce mortality.

关 键 词：动脉导管未闭 急诊处理 婴儿 新生 

分 类 号：R543.5[医药卫生—心血管疾病]