经左胸胸骨旁途径动脉导管未闭微创封堵手术及术后管理  

The operation and postoperative management of minimally invasive occlusion of patent ductus arteriosus via left chest parasternal approach

作　　者：邝素华[1] 马伦超[1] 陆国梁[1] 杨超[1] 张英元[1] 方剑[2] 任晓山[1] 梁庆[3] 谢少波[1] 

机构地区：[1]广州医科大学附属第一医院心脏外科,广州510120 [2]广州医科大学附属第一医院麻醉科,广州510120 [3]广州医科大学附属第一医院急诊科,广州510120

出　　处：《广东医学》2015年第13期2011-2013,共3页Guangdong Medical Journal

基　　金：广东省医学科研基金立项课题(编号:A2014287);广州市医药卫生科技一般引导项目(编号:20141A011077)

摘　　要：目的总结经左胸胸骨旁途径微创封堵动脉导管手术及术后管理经验。方法回顾性分析21例接受食管超声心动图引导经左胸胸骨旁途径动脉导管未闭封堵手术患者的临床资料。结果 21例成功完成封堵手术,全组无术中中转开胸及输血,术后无封堵器脱落、溶血、心律失常、二次开胸等并发症。全组随访1-10个月无并发症,出院后返院复查心脏彩超均未见残余分流及封堵器移位。结论经左胸胸骨旁途径微创封堵动脉导管未闭安全、创伤小、恢复快,值得推广;优质的术后管理配合保证手术成功及促进术后康复。Objective To summarize the postoperative management experience of minimally invasive occlusion of patent ductus arteriosus via left chest parasternal approach. Methods Retrospective analysis of the clinical data of 21 cases that received transesophageal echocardiography guided left chest parasternal approach minimally invasive occlusion of patent ductus arteriosus was conducted. Results Successful plugging operations were performed in all 21 cases,with no intraoperative conversion to thoracotomy or blood transfusion,nor postoperative complications,including occluder detachment,hemolysis,arrhythmia or secondary thoracotomy. All the patients were followed up for 1- 10 months without complications,and echocardiography review after discharge showed no residual shunt and occluder shift. Conclusion The left chest parasternal approach for minimally invasive occlusion of patent ductus arteriosus is worthy to promote due to the safety,less trauma and quick recovery. High quality postoperative management can ensure the successful operation and accelerate the postoperative recovery.

关 键 词：胸骨旁途径 食管超声心动图 动脉导管未闭 封堵 术后管理 

分 类 号：R654.2[医药卫生—外科学]