目的
探讨胸部正中小切口在婴幼儿先天性心脏病手术治疗中的可行性及效果。
方法
将我院 2016 年 5 月至 2016 年 10 月 170 例行手术治疗的常见先天性心脏病婴幼儿患者分为两组:常规组,85 例,男42例、女43例,年龄(6.9±2.1)个月,采用常规胸部正中切口;小切口组,85 例采用胸部正中小切口,男43例、女42例,年龄(6.4±1.8)个月。小切口手术切口于平第 3 肋间切开,止于剑突起始处上 0.5 cm,刚好放入小胸骨撑开器为好。
结果
两组患儿体外循环时间差异无统计学意义(P>0.05)。小切口组手术时间略长(P<0.05)。两组预后没有差别,但是小切口组伤口长度显著缩短[(7.8±0.8) cmvs. (4.0±0.5)cm,P<0.05]。
结论
正中小切口基本具有胸骨正中切口的优点,可显露心脏各部位,满足绝大部分心脏探查和手术操作需要,必要时仍可向上延长切口使心内操作不受限制等优点,故认为正中小切口在婴幼儿心脏手术中具有良好的安全性和美观性。
Citation:
殷强, 韩跃虎, 杨勇, 朱海龙, 孙国成, 彭岚刚, 魏东明, 段乐, 顾春虎. Analysis of 85 infants of minimal median sternotomy for cardiac surgery under cardiopulmonary bypass. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(10): 807-810. doi: 10.7507/1007-4848.201612014
Copy
Copyright © the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved
1. |
Doty DB, Flores JH, Doty JR. Cardiac valve operations using a partial sternotomy (lower half) technique. J Card Surg, 2000, 15: 35-42.
|
2. |
朱晓东. 我国微创心脏外科的现状和思考. 中国微创外科杂志, 2003, 3: 369-371.0.
|
3. |
Lichtenberg A, Klima U, Harringer W. Mini sternotomy for off-pump coronary artery bypass grafting. Ann Thorac Surg, 2000, 69: 1276-1277.
|
4. |
Gundry SR, Shattuck OH, Razzouk AJ, et al. Facile minimally invasive cardiac surgery via mini sternotomy. Ann Thorac Surg, 1998, 65: 1100-1104.
|
5. |
宋毅. 右腋下小切口行心内直视手术临床效果分析. 临床和实验医学杂志, 2012, 11: 1872-1873.0.Ref.
|
6. |
Guedes MA, Pomerantzeff PM, Brandao CM, et al. Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure. Rev Bras Cir Cardiocasc, 2010, 25: 322-325.
|
- 1. Doty DB, Flores JH, Doty JR. Cardiac valve operations using a partial sternotomy (lower half) technique. J Card Surg, 2000, 15: 35-42.
- 2. 朱晓东. 我国微创心脏外科的现状和思考. 中国微创外科杂志, 2003, 3: 369-371.0.
- 3. Lichtenberg A, Klima U, Harringer W. Mini sternotomy for off-pump coronary artery bypass grafting. Ann Thorac Surg, 2000, 69: 1276-1277.
- 4. Gundry SR, Shattuck OH, Razzouk AJ, et al. Facile minimally invasive cardiac surgery via mini sternotomy. Ann Thorac Surg, 1998, 65: 1100-1104.
- 5. 宋毅. 右腋下小切口行心内直视手术临床效果分析. 临床和实验医学杂志, 2012, 11: 1872-1873.0.Ref.
- 6. Guedes MA, Pomerantzeff PM, Brandao CM, et al. Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure. Rev Bras Cir Cardiocasc, 2010, 25: 322-325.