摘要
目的:比较右腋下直切口与胸部正中切口两种手术路径,在心内直视手术治疗常见先天性心脏病(先心病)的临床结果。方法:回顾性分析2012年5月至2014年2月,常见简单先心病房间隔缺损、室间隔膜部缺损、部分性心内膜垫缺损行微创右腋下直切口心内直视手术33例,选取既往相同疾病行传统胸部正中切口41例。对比两组患者手术时间、体外循环时间、输血量、术后引流量、术后呼吸机使用时间、术后住院时间及预后并进行总结。结果:两组患者均无死亡、出血致二次手术等重大并发症,在体外循环时间、术后呼吸机使用时间上两组比较,差异无统计学意义(P>0.05),而在手术时间、输血量、术后引流量和术后住院时间方面微创右腋下直切口组均优于传统胸骨正中切口组,差异有统计学意义(P<0.05)。术后随访6个月,两组患者超声心动图(UCG)均未发现残余分流、心包积液等并发症,传统胸部正中切口组4例患者出现鸡胸畸形,而微创切口组均恢复良好。结论:在常见先心病心内直视手术治疗中,微创右腋下直切口安全美观,并不增加术后并发症的发生,在术后恢复上显著优于传统胸骨正中切口。
Objective：To compare the clinical outcomes of minimal invasive right subaxillary vertical thoracotomy and traditional median sternotomy in treatment of common congenital heart diseases through right a- trium. Methods： Clinical data of 33 cases of common congenital heart diseases treated with minimal invasive right subaxillary vertical thoracotomy from May, 2012 to February, 2014 and 41 cases of same diseases with tra- ditional median sternotomy in the past three years were retrospectively analyzed, including atrial septal defect, membranous ventrieular septal defect and partial endocardial cushion defect. The data were compared between the two groups, including the time of operation and cardiopulmonary bypass, amount of blood transfusion, post- operative drainage, ventilator time, hospital stay, and prognosis. Results： No severe complication happened in both groups, like death or reoperation caused by bleeding. There was no significant difference between the two groups in CPB time and postoperative ventilator time （ P 〉 0. 05 ）, while in all of the operative time, the length of incision, postoperative drainage and hospital stay, minimal invasive right axillary vertical thoracotomy was significantly better than median sternotomy （P 〈 0. 05）. In six-month follow up after operation, no complica- tions such as residual deformity and pericardial effusion were found in both groups by echocardiography follow- up, but mild pectus carinatum was found in 4 patients in the traditional median sternotomy group, whereas pa- tients in another group were well recovered uneventfully. Conclusion： Minimal invasive right subaxillary verti- cal thoracotomy for common congenital heart diseases is as safe as traditional median sternotomy. Additionally, compared with traditional median steruotomy, minimal invasive right subaxillary vertical thoracotomy is better inthe aspects of hidden incision, appearance, anti postoperative recovery.
出处
《心肺血管病杂志》
CAS
2015年第6期477-479,495,共4页
Journal of Cardiovascular and Pulmonary Diseases
关键词
先天性心脏病
右腋下直切口
心脏外科手术
Minimal invasive
Congenital heart disease
Right subaxillary vertical thoracolomy
