改良保护液在室间隔缺损合并动脉导管未闭的应用

目的:回顾性分析改良心肌保护液在59例室间隔缺损(VSD)合并动脉导管未闭(PDA)外科治疗的临床资料,探讨其外科治疗经验。方法:研制的改良心肌保护液是在全面细致分析UW液、HTK液配方的基础上,加以改良,并应用腺苷和中药丹参,即集中UW液、HTK液及祖国医学的优点,采用体外循环心脏停跳下行动脉导管结扎或缝合术以及VSD修补术,其中男21例,女38例,年龄2个月~38岁;直接分离结扎导管19例;其余病例经肺动脉切口缝合;其中利用补片修补动脉导管3例。结果:全组无死亡,随访3个月~7年,复查心脏超声均未发现VSD残余分流,无远期死亡病例。结论:改良的保护液与ST.Thomas液对心肌有良好的保护效果。VSD合并动脉导管未闭一旦明确诊断,应该早期手术治疗,以避免肺动脉高压的发生,手术中探查和进行肺动脉压力,主动脉压力比值测定有助于手术方式的选择和制定围手术期处理方案,心脏不停跳技术可作为安全有效的方法应用于VSD合并PDA的外科治疗。

Improved cardioplegia preservation solution in ventricular septal defect with patent ductus arteriosus in the heart of myocardial protection during open heart surgery for the clinical observation

Objective：A retrospective analysis of clinical data of improved-cardioplegia in 59 patients with ventricular septal defect （VSD） combined with patent ductus arteriosus （PDA） treatment, and to explore the surgical treatment. Methods： improved myocardial preservation solution is a comprehensive and detailed analysis of UW solution, HTK solution based on the formula, to be improved, and adenosine and Chinese medicine Danshen, the concentration of UW solution, HTK solution and the advantages of Chinese medicine, in vitro Circulating cardiac arrest downstream arterial ligation or suturing, and VSD repair, including 21 males and 38 females, aged 2 months of a 38-year-old; direct separation duct ligation in 19 cases; the remaining cases were pulmonary artery incision; which use up Patch in 3 cases of patent ductus arteriosus. Results： No deaths, followed up 3 months to 7 years, the review found no cardiac ul- trasound residual VSD shunt. No long-term mortality. Conclusions： The improved protection of fluid and ST.Thomas a good solution on myocardial protection effect. VSD combined with patent ductus arteriosus, once diagnosed, surgical treat ment should be early to avoid the occurrence of pulmonary hypertension, surgical exploration and for pulmonary arterial pressure, aortic pressure ratio determination of choice of surgical approach and contribute to development ofperioperative.