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[开胸手术与胸腔镜手术治疗体重小于2500克婴儿动脉导管未闭]

[Thoracotomy and thoracoscopy in the treatment of patent arterial duct in infants weighing less than 2500 g].

作者信息

Kozlov Iu A, Novozhilov V A, Ezhova I V, Medvedev V N, Medvedev A V, Iaroshevich A V, Mikheeva N I, Syrkin N V, Kononenko M I, Kuznetsova N N

出版信息

Khirurgiia (Mosk). 2014(1):64-72.

Abstract

BACKGROUND

Thoracoscopic clipping of the patent ductus arteriosus is an alternative to conventional surgical closure via thoracotomy in low birth weight infants. The aim of this study is to compare of these two groups of patients for the last 11 years.

METHODS

We reported the data of 127 small children's who underwent standard transaxillary thoracotomy (101 patients - Group I) and video-assisted thoracoscopic surgery for patent ductus arteriosus clipping (26 patients - Group II). The two groups were compared for patients demographics, operative report and postoperative parameters.

RESULTS

The groups were similar in terms of demographics and preoperative parameters. There was significant difference in mean operative time between open and thoracoscopic procedure (44.65 min vs 38.46 min; p<0.05). Duration of care in neonatal intensive unit and length of hospital stay were significantly shorter in the Group II (16.44 d vs 8.77 d; p<0.05 and 40.13 d vs 33.65 d; p<0.05). Early complication rates were equivalent between groups (6.93% vs 3.85%; p>0.05). Rate of long-term complications was dominated in the thoracotomy group (19.80% vs 0%; p=0127).

CONCLUSION

Thoracoscopic ligation of the patent ductus arteriosus in infants less than 2500 g gave results better than open surgery.

摘要

背景

对于低体重婴儿,胸腔镜下结扎动脉导管未闭是开胸手术传统闭合方法的一种替代方案。本研究旨在比较过去11年中这两组患者的情况。

方法

我们报告了127例小儿患者的数据,其中101例接受标准经腋窝开胸手术(I组),26例接受电视辅助胸腔镜手术结扎动脉导管未闭(II组)。比较两组患者的人口统计学资料、手术报告和术后参数。

结果

两组在人口统计学资料和术前参数方面相似。开胸手术和胸腔镜手术的平均手术时间有显著差异(44.65分钟对38.46分钟;p<0.05)。II组新生儿重症监护病房的护理时间和住院时间显著缩短(16.44天对8.77天;p<0.05和40.13天对33.65天;p<0.05)。两组早期并发症发生率相当(6.93%对3.85%;p>0.05)。开胸手术组长期并发症发生率更高(19.80%对0%;p=0.127)。

结论

对体重小于2500克的婴儿进行胸腔镜下结扎动脉导管未闭的效果优于开胸手术。

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