右侧开胸手术治疗先天性心脏病

Right thoracotomy for congenital heart disease

目的探讨右侧开胸体外循环手术治疗先天性心脏病的应用指征及效果。方法回顾性分析678例经右侧开胸体外循环手术治疗的先天性心脏病患者的临床资料。结果室间隔缺损修补术512例,房间隔缺损修补术113例,法洛四联症根治术32例,部分型心内膜垫缺损矫治术11例,三房心矫治术5例,其他畸形手术5例;本组手术无死亡病例,术后发生并发症28例,其中术后出血行开胸止血6例,迟发心包积液经心包引流1例,Ⅲ度房室传导阻滞安装永久起搏器1例,<2mm的残余分流19例,行二次气管插管1例。结论右侧开胸手术治疗先天性心脏病由于切口隐蔽,创伤小,术后恢复快,对患儿心理影响较小,在熟练掌握常规手术技术及特殊手术技巧的基础上,是治疗先天性心脏病的较好选择。

Objective To explore the indication and effect of right thoracotomy on congenital heart disease.Methods The indication and effect of cardiopulmonary bypass through right thoracotomy were analyzed in patients with congenial heart disease.Results Ventricular septal defect repairs were performed in 512 cases,atrial septal defect repairs in 113 cases,tetralogy of Fallot corrections in 32,partial endocardial cushion defect corrections in 11,Cor Triatrium corrections in 5 and other defect repairs in 5.No death occurred.Complications occurred in 28 cases,including 6 reopen surgeries due to bleeding,1 pericardial drainage for delayed cardiactamponade,1 pacer placed for degree Ⅲ atrioventricular block,19 resident shunt smaller than 2 mm,and 1 retubated postoperatively.Conclusion Surgical correction of congenital heart disease through right thoracotomy is a good option,because of less trauma and rapid recovery.