成人动脉导管未闭合并中重度肺动脉高压外科治疗的临床分析.docVIP

精品论文 参考文献 成人动脉导管未闭合并中重度肺动脉高压外科治疗的临床分析 丘智煌 陈道中 黄忠耀 陈道中(通信作者)（福建医科大学附属协和医院心血管外科 350001） 【中图分类号】R543 【文献标识码】A【文章编号】1672-5085（2012）4-0450-03 【摘要】目的 评价经胸小切口封堵术在治疗成人动脉导管未闭合并中重度肺动脉高压患者的临床疗效。方法 回顾性分析我院心脏外科2005年1月至2011年7月共收治成人动脉导管未闭合并中重度肺动脉高压患者51例，男16例，女35例；年龄31.1plusmn;7.6岁（18-47岁）；其中27例患者采用经胸小切口封堵治疗，24例患者采用体外循环外科手术治疗。结果 所有患者均顺利出院，无1例死亡。采用这两种手术方式患者的术后3个月肺动脉压力与术前相比明显下降，但经胸小切口封堵组与体外循环手术组相比，其手术时间短、术后呼吸机使用时间短、住院时间短，术后恢复快。结论 经胸小切口封堵治疗成人动脉导管未闭合并中重度肺动脉高压，术后肺动脉压均较术前下降，疗效确切，其与体外循环手术治疗相比具有创伤小、术后恢复快等优点，安全可行，但一些特殊类型患者仍需体外循环手术治疗。 【关键词】 动脉导管未闭 经胸小切口 体外循环 肺动脉高压 Clinical analysis of surgical treatment for adult patent ductus arteriosus complicated with sereve pulmonary hypertension Qiu zhihuang, Chen daozhong, Huang zhongyao ,Surgical Department ,Union Hospital of Fujian Medical University, Fuzhou 35001,China 【Abstract】 Objective To evaluate the efficacy of mini-incision transthoracic occlusion for patent ductus arteriosus complicated with sereve pulmonary hypertension. Methods Betweed January 2005 and July 2011,51 pateints [16 male,35 female,age from 18 to 47(31.1plusmn;7.6)yeras] with adult patent ductus arteriosus complicated with sereve pulmonary hypertension were hospitalized in our hospital.27 patients were treated by mini-incision transthoracic occlusion.24 patients were received on-pump surgical operation. Results All the patients were discharged from hospital.3 months after operation, patients of pulmonary artery pressure compared with preoperative decreased obviously. Compared with the on-pump group, patients in the occlusion group had shorter operation time, mechanical ventication time, ICU stay time, and faster recovery. Conclusion Mini-incision transthoracic occlusion for PDA complicated with sereve pulmonary hypertension was safe,reliable, but some special types of patients still needed for on-pump operation treatment. 【Key words】 patent ductus arteriosus transthoracic mini-incision cardiopulmonary bypass pulmonary artery hypertension 动脉导管未闭是临床上