电视辅助胸腔镜钳闭治疗动脉导管未闭

被引：8

作者：

谢斌

张镜芳

庄健

Devi Shetty

机构：

[1] 广东省人民医院心外科,广东省人民医院心外科,广东省人民医院心外科,印度班加罗尔Manipal心脏基地

来源：

中华外科杂志 | 2001年 / 06期

关键词：

胸腔镜检查; 动脉导管未闭; 心脏外科手术;

D O I：

暂无

中图分类号：

R654.2 [心脏];

学科分类号：

1002 ; 100210 ;

摘要：

目的　总结电视辅助胸腔镜钳闭未闭动脉导管的经验。　方法　用电视辅助胸腔镜技术对 130例动脉导管未闭患儿进行了手术。在全麻和单侧肺通气的情况下 ,在左侧第 3肋间脊柱肩胛骨旁做 2cm的切口 ,用以导入器械。在左侧第 4肋间腋中线做相似的切口以导入镜头。在左侧第3肋间胸骨旁 2cm和左侧第 4肋间胸骨旁 1cm各做 1孔 ,用以放入长而钝的神经钩暴露术野。通过器械窗导入持Ethicon 1cm钛夹的持夹器钳闭未闭的动脉导管。整个手术过程在电视荧屏上观看 ,食管B超和床边B超监测术中和术后的效果。　结果　本组患儿 ,平均年龄 (2 8± 1 2 )岁 ,平均体重(7 9± 4 5 )kg,平均肺动脉压 (35± 7)mmHg。合并心内畸形包括 :房间隔缺损 2例 ,室间隔缺损 3例。平均动脉导管直径 (6 8± 3 1)mm。手术平均时间 (30± 19)min。术后残余分流 4例 ,开胸结扎残余分流导管 3例 ,喉返神经麻痹 3例 ,5例转为开胸结扎。本组无手术死亡病例 ,无术后出血、手术输血、乳糜胸患儿。　结论　电视辅助胸腔镜钳闭未闭的动脉导管是治疗动脉导管未闭的一种较好方法 ,具有安全、快速、费用少、效果好、易学的特点

引用

页码：33 / 35

页数：3

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