小儿心内术右腋下微创小切口与胸部正中切口对比

Congenital Heart Disease through the Right Subaxillary Minithoracotomy and the Midsternal Incision Approach

目的:通过对两种切口术后胸腔引流量和住院天数的比较,观察先天性心脏病患儿经右腋下小切口剖胸体外循环下行心内直视手术的疗效。方法:A组19例患者采用右腋下微创小切口,B组25例同期采用正中剖胸入路行心内直视术,术后均给予胸腔及心包、纵隔引流管的常规护理。结果:A组与B组的患者相比,胸腔引流量分别为A组平均130ml;B组平均448ml;术后住院天数平均9.8d、14.2d,差异有显著性(P<0.01)。结论:右腋下微创小切口剖胸治疗小儿先天性心脏病较常规正中剖胸入路可减少术后胸腔引流量和术后住院天数。

Objective：the paper compares pleual drainage volumes and hospital stays of two kind of surgeries on children＇s congenital heart disease,and observes the therapeutic effect of the intracardiac surgery performed through the right subaxillaly thoracotomy with mini-incision under the premise of extracorporeal circulation.Methods：19 patients are listed into group A,on whom the surgeries are operated with right subaxillary minimal invasive incision,and a closed right thoracic drainage tube is respectively carried by them after surgery.Meanwhile,25 other patients are operated through the midsternal incision approach;hereafter each holds pericardium and mediastinum drainage tube.Afterwards,the normal nursing is carried out on both the thorax and the pericardium and mediastinum drainage tube.Result：The obvious different result is obtained（P〈0.01） by the data comparison of group A and B,in which the pleural drainage volumes are within the ranges of 103～157ml,average130 ml;and 150～650ml,average 448 ml;while the hospital stays after surgery are 9～12 days,average9.8 days and 12～15 days average14.2 days respectively.Conclusion：As observed,the surgery through the right subaxillary thoracotomy with minimal invasive incision can effectively reduce the pleural drainage volume as well as the hospital stay after surgery more than the normal midsternal incision approach.