体外循环下动脉导管未闭直视闭合术方法探讨

目的探讨体外循环下动脉导管未闭直视闭合术的手术方法.方法回顾分析33例不同方法体外循环下动脉导管未闭直视闭合术手术经验.包括深低温低流量心脏停跳下动脉导管未闭(PDA)直视闭合术8例(1组);深低温低流量心脏颤动下PDA直视闭合术11例(2组);常温体外循环心脏跳动下应用Foley尿管PDA直视闭合术14例(3组).结果三组患者均无手术死亡.主要并发症有术后气胸1例,肺不张2例,肺部感染2例.体外循环时间、呼吸机辅助时间、术后监护时间、术后出血量,1组与3组、2组与3组之间差异有统计学意义,P＜0.05.1组与2组间差异无统计学意义,P＞0.05.结论常温体外循环心脏跳动下应用Foley尿管PDA直视闭合术手术操作方法简单,对机体创伤小,术后恢复快,是一种较为安全可靠的手术方法.

PATENT DUCTUS ARTERIOSUS UNDER CARDIOPULMONARY BYPASS

Objective To approach patent ductus arteriosis (PDA) under cardiopulmonary bypass (CPB). Methods We retrospectively analyzed the experiences of PDA under CPB including deep hypothermia and circulatory arrest(group 1, n = 8);heart vibrating with deep hypothermia and low flow technique(group 2, n=11) and heart beating under normal thermia CPB with Foley tube(group 3, n =14). Results No surgical death occurred among three groups. The main complications were pneumothorax(1 case), atelectasis and pulmonary infection (2 cases respectively). Statistics shown significant differences in the CPB time, ventilation time, stay in ICU time and the postoperative bleeding volume between group 1 and 3, group 2 and 3. There had no significant difference in the results between group 1 and 2. Conclusion The method of group 3 is simple and secure and reliable. There are many advantages such as small trauma and quicker recovery etc.