成人房间隔缺损三种不同手术方式临床对比分析

Clinical comparison of atrial septal defect repair with different surgical process

目的:通过正中开胸、右胸前外侧切口、全胸腔镜下房间隔缺损修补的临床对比,研究不同方式房间隔缺损修补的优缺点。方法:选取2007年7月至2010年6月房间隔缺损修补术患者131例,根据手术切口的不同,分为正中开胸组63例、右胸切口组37例、胸腔镜组31例,比较不同组间住院相关时间、主动脉阻断时间、体外循环时间、引流量及住院费用等。结果:住院时间、胸管引流量差异有统计学意义(P<0.05),而在主动脉阻断时间、体外循环时间、住ICU时间、呼吸机辅助时间及住院费用方面差异无统计学意义(P>0.05)。结论:右胸前外侧切口、全胸腔镜下房间隔缺损修补术与传统正中开胸手术比较各具优缺点,同样安全有效,但对于成人全胸腔镜下房间隔缺损修补术患者住院时间短、手术创伤小、不横断胸骨及切口美观,符合现代健康理念,更具有优势。

Objective：To analyze advantages and disadvantages of atrial septal defect repair with sternal incision, right lateral chest incision, and totally thoracoscopic process. Methods： From July 2007 to June 2010, 131 patients with atrial septal defect repair were divided into sternal incision group, right lateral chest in- cision group,and totally thoracoscopic process group for comparing hospital stay, operation time, aortic cross- clamping time, CPB time, amount of drainage and so on. Results： There were significant difference （ P 〈 0. 05） in hospital stay, and amount of drainage and there were no significant difference （ P 〈 0.05 ） in aortic cross-clamping time;operation time, ICU stay and ventilation time. Conclusion： Operation with sternal inci- sion, right lateral chest incision,and totally thoracoscopic process is safe and effective although there were of different advantages and disadvantages. But the totally thoracoscopic process is better than others.