微创手术在胸心外科的临床应用38例报告

Ginical application of minimal invasine surgery for the fieid of thoracic cardiovascular surgeky

为了减小胸部创伤和手术并发症,提高疗效。我们采用胸部小切口,对38例患者进行手术治疗。其中先心病动脉导管未闭(PDA)10例,房间隔缺损(ASD)12例,室间隔缺损(VSD)1例,风心二尖瓣病变8例,纵膈肿瘤2例,肺癌2例,贲门痉挛2例,左心房粘液病(LAM)1例。切口位于胸部腋下,呈“L”,“I”或“S”形,长8～12 cm。切开皮肤,于胸肌和前锯肌之间钝性分开,经相应肋间进胸,即可以显露病变进行手术。这种切口,不切断胸部大片肌肉,减小神经、血管损伤,不需正中劈开胸骨,不切断肋骨,保存了胸廓骨性完整性和隐定性,术后疼痛小,利于咳嗽排痰,防止肺部并发症。术后恢复快,后遗症少,提高手术疗效,切口隐蔽腋下,符合美容观念,有广泛应用前景和实用价值。

We have designed and practised the small thoracic incision to operate thirty - eight thoracic cardiovascular patients in order to reduce thoracic injury and complication. This patients included 10 casese of PDA (patent ductus arteriosus) , 12 cases of ASD (atrial septal defect) . 1 cases of VSD (Ventricular septal defect), 5 cases of mitral valve disease,2 cases of mdeiastical tumors,2 cases of lung carcinoma. 2 cases of cardia spasma. 1 case of left atrial myxoma.' L',' I' or 'S' shape skin incision was made fristly, through the spatium intercostale, then the tissue between greater peltoral muscle and serratus anterior muscle was tored up blundy, Finally the field of operation apeared.This incision is concealed under the armpit and only 8cm to 12cm long, It has the advantage of causing mininal nerve, vascular, rid and big muse-les of thorax distarbane, keeping thoracis united,having less thoracolgic postoperation and avoiding complocation of lung infection. The clinical results proved that the effectiveness of this type of surgery was significant . All patients had a good recovery, less complication and better cosmetic effectiveness. The procedure apears a good future and could be widely applied on a clinical bases soon.