合并心内畸形动脉导管未闭的一期外科治疗

目的探讨合并心内畸形动脉导管未闭(PDA)的一期外科治疗及预防术中灌注肺的方法。方法26例患者，5例采用正中劈胸骨经心包外分离双重结扎PDA，5例外循环心脏不停跳下切开肺动脉直视缝闭PDA，16例深低温体外循环辅助心脏停跳下切开肺动脉直视缝闭PDA，同期行心内畸形矫治。结果1例出现围手术期肺灌注，无早期死亡病例，均痊愈出院，随访2个月至4年，恢复良好，无晚期死亡。结论心内畸形合并PDA应早行同期矫治，体外循环前或阻断主动脉前结扎或缝闭PDA能明显降低肺部并发症。

One stage surgical treatment of patent ductus arteriosus associated with intracardiac malformation

Objective To evaluate one stage surgical tech niques for patent ductus arteriosus (PDA) associated with intracardiac malformation.Methods Twenty six patients underwent surgical treatments , including double ligation for closure of the ductus via median sternotomy(n =5), direct suture through pulmonary artery under cardiopulmonary bypass with or without heart beating(n=16, 5), and the intracardiac malformation was repaired at the same time. Results One patient was complicated with pulmonary perfusion, all patients had a good recovery in a period of 2 months to 4 years followup. Conclusion Simultaneous operations on patients with intracardiac malformation and PDA are safe and effective. PDA should be treatments before CPB or before aotic artery cross clamp, it will reduce the pulmonary comp lication.