中断肋骨进胸切口（附100例报道）

INCISON OF ENTRY INTO THE PLEURAL SPACE THROUGH CUTTING THE MIDDLE OF A RIB:REPORT OF 100 CASES

施行肺、食管等胸外科手术的传统进胸切口是肋床切口和肋间切口。肋床切口较肋间切口暴露范围大，但需切除肋骨，手术创伤较大，并因肋骨切除有损肺功能和造成胸壁局部凹陷畸形．作者设计的中断肋骨剖胸切口，已用于各类胸外科手术１００例，术野暴露范围与肋床切口相仿但保留肋骨。术后病人咳嗽有力，下床活动早，无胸壁畸形和胸壁局部软化。术后３周Ｘ片示中断的肋骨对位好。１００例中无一发生术后肺不张和因胸壁切口部出血而再次剖胸止血。

Customary thoracotomy entry for pulmonary and esophageal operation is intercostalincision or rib resection and incision of periosteal bed. Incision through the periostealbed gives larger exposure but more tissue injury than that through the intercostal space. The resected rib gives rise to local deforming depressed chest wall and decreases pulmo- nary function. We have devised a thoracotomy incision by dividing the middle partion of a riband enter the pleural space through rib bed.This method has been used in one hundredsurgical patients The exposure is similar to that obtained by incision of periosteal bed. After operation patients could cough more effectively and get out of bed early. No pa-tient suffered from atelectasis.Neitner deformity nor softening of the thoracic wallwere developed.Three weeks after operation the X-ray film showed good alignmen ofthe divrded rid ends.