应用正中小切口矫治先天性心脏病52例观察

Therapeutic effect of median minor incision for congenital heart diseases

目的 评价正中小切口手术应用于先天性心脏病手术的效果.方法 取胸骨正中切口从胸骨角下方1 cm 至剑突水平切开皮肤,长约5～10 cm.纵劈胸骨至第2肋间、向右侧横断胸骨.常规建立体外循环,行先天性心脏病直视手术52例.并与同期采用常规正中切口矫治的同类型先天性心脏病手术55例进行比较.结果 正中小切口组的体外循环时间、主动脉阻断时间与常规正中切口组相比无显著延长(P>0. 05),但小切口组术后引流量较常规切口组明显减少 (P<0.05).术后循环稳定,切口小、疼痛反应轻,无切口感染和胸骨畸形愈合等并发症.结论 胸骨正中小切口可用于先天性心脏病手术的矫治,该术式创伤小、切口美观.

Objective To evaluate the therapeutic effect of minor median sternotomy for congenital heart surgery.Methods 52 patients with congenital heart diseases were operated by median minor incision.The incision was made from the xiphoid process to the second intercostal level and it was only 5-10 cm long.Routine cardiopulmonary bypass was used in 52 cases of open heart surgery and compared the surgical results with 55 cases of routine incision operations.Results The cardiopulmonary bypass time and clamping time did not prolonged significantly in the minor incision group compared with the routine incision group(P>0.05),but the drainage bleeding volume in the minor incision group was less than the routine group(P<0.05).All cases were cured and no sever complications and infection occurred.Conclusion The median minor sternotomy for many congenital open heart surgery is safe.Cosmetic effects and fewer traumas could be achieved satisfactorily.