右腋下微创小切口心内直视手术的临床应用分析

Application analysis of right subaxillary minimally invasive small incision in open heart surgery

目的探讨右腋下微创小切口在体外循环下行心内直视手术的临床应用及安全性。方法选择大理学院附属医院外科2001年10月至2010年10月收治的先天性心脏病及风湿性二尖瓣病变患者112例,均采用腋下第3或第4肋间微创小切口进行心内直视手术。结果本组患者无手术死亡,术后发生胸腔积液8例,余无其他并发症发生。心肌阻断时间为(21.0±5.5)min,术后住院时间为(8.0±2.3)d。随访3～16个月患者均恢复良好。结论采用右腋下微创小切口在体外循环下进行心内直视手术创伤小,恢复快,住院时间短,术后并发症少以及切口隐蔽、美观。

Objective To study the clinical application and safety of right subaxillary minimally invasive small incision in open heart surgery under extracorporeal circulation.Methods From October 2001 to October 2010,112 cases of congenital heart disease and rheumatic bicuspid disease were performed open heart surgery through right subaxillary minimally invasive small incision of 3rd or 4th intercostal space.Results The operation were successfully performed.There were no operative deaths.Postoperative pleural effusion occurred in 8 cases without other complications happening.The cardiopulmonary bypass time was（21.0±5.5） min,postoperative hospital stay was（8.0±2.3） d.Conclusion The open heart surgery through right subaxillary minimally invasive small incision under hypothermic cardiopulmonary bypass has little trauma,rapid recovery,short hospital stay,less postoperative complications,hided and aesthetic incision.