右胸小切口心内直视术52例的临床应用

Clinical Application of open-heart opertion through small Right Incision thoracectomy in fifty-two patients

目的 总结右胸小切口心内直视手术临床应用体会。方法 对1997.10～1998.12本院经右胸小切口施行的心内直视手术52例进行总结分析。结果 术中心肌阻断时间、术后辅助呼吸时间以及ICU停留时间等与常规正中开胸无显著差异;但术后疼痛时间及其程度都明显缩短及减轻,无手术并发症及手术死亡。结论 右胸小切口心内直视术具有创伤小、恢复快和伤口隐蔽、美观等特点,易为患者接受。但必须选择适当的病例和相应的手术器械,才能保证手术顺利实施。

Objective: Summarize experience of open- heart operations through small right incision thoracectomy.Methods: Analysis fifty - tow patients who were accepted open- hrart operations with small right incision thoracectomy by the same surgeon from October 1997 to December 1998. Patients age ranged from one to twenty - three years. Incision was made into 3rd or 4th intercostales. Twenty - six patients experience direct close of ventricular septal defect(VSD) and eighteen patients experience patching of VSD. Eight patients experience patching of atrial septal defect. Results: Compare with the routine middle incision thoracectomy operation, there is no apparent different from occlusion time of aortic artery, respire - assistance time and monitoring time of ICU. But pain was lightened and pain - continuing time was shortened notably after operation. No patients occurred deformation of thoraces or infection of mediastinum. There was no delay curing of wound for expelling the bone wax too. All patients were cured. Conclusion ; Compare with routine operation, small right incision thoracectomy operation has such advantages as the wound is smaller and recovering is more quichly. What s more the wound is hide and good looking. So it is more acceptable by patients. But it is important that the patients must be proper selected, moreover some special apparatus are necessary to perform the operation.