胸骨正中小切口在心脏直视手术中的应用

The use of limited sternotomy for open heart surgery

目的:探讨胸骨正中小切口在心脏直视手术中的临床应用价值。方法 :对 4 0例风湿性心脏病、先天性心脏病患者 ,在常规体外循环下行心内直视手术。其中行二尖瓣置换术 18例 ,主动脉瓣置换术 12例 ,房间隔缺损修补术 10例。分别采用胸骨正中上段或下段部分胸骨劈开切口 ,切口长约 7～ 9cm。结果 :本组 4 0例无围术期死亡者。术后恢复快 ,无严重的并发症 ,术后纵隔引流量少 ,输血量少 ,无切口感染、裂开。手术效果满意。结论 :胸骨正中小切口可安全用于多种心脏直视手术 ,具有创伤小、胸骨完整性破坏小、疗效好及美观的优点。

Objective: To review the experiences of using limited sternotomy for open heart surgery. Methods: From August 2000 to October 2003, 40 patients with rheumatic heart disease or congenital heart diseases received open heart surgery under cardiopulmonary bypass through limited sternotomy, which including mitral valve replacement in 18, aortic valve replacement in 12. atrial septal defect in 10. The incision was 7～9 cm long. Results: There was no death perioperatively. There was no serious complication, few amount of drainage and transfusion postoperatively. The patients recovered quickly and had no wound dehiscence. Conclusion: The limited sternotomy can be used safely in many open heart surgery. It has less surgical trauma, stable sternum and satisfactory, reform results.