心内直视手术中右腋下直切口的应用及体外循环插管的策略

The Application of Right Subaxillary Small Incision in the Open Heart Surgery

目的探讨右腋下直切口在体外循环(CPB)心内直视手术中的应用。方法1999年3月—2005年6月,采用右腋下直切口经右第3肋床进胸行心内直视手术,其中房间隔缺损(ASD)67例,室间隔缺损(VSD)141例,ASD加VSD15例,共计223例。结果心肌阻断时间为22.0min±5.5min,1/3病人不输血,无死亡,术后住院时间6.0d±4.5d。结论采用右腋下直切口在CBP心内直视手术治疗单纯ASD、VSD,创伤小,恢复快,住院时间短,输血量少,术后并发症少以及切口隐蔽、美观。

Objective The aim was to introduce the experience of open heart surgery through the right subaxillary small incision, Methods Two hundred and twenty-three patients （pts） with congenital septal defect were repaired through right subaxillary small incision in hypothermic cardiopulmonary bypass, including 67 pts with ASD, 141 pts with VSD,15 pts with ASD and VSD. Results The operation were successfully performed with exposure. The cardiopulmonary bypass time was 22.0± 5. 5 minutes, There were no blood transfusion and mortality, Hospital stay was 6.0 ± 4.5 days, Conclusion The cardiac septal defects repaired through right subaxillary small incision was superior to median sternotomy.