再次开胸手术治疗先天性心脏病患者200例效果分析

Result analysis of 200 repeat sternotomies in pediatric cardiac operations

目的分析和总结再次开胸治疗先天性心脏病的外科技术和和临床结果。方法回顾分析2012年1月～2014年1月阜外医院小儿中心再次开胸手术治疗先天性心脏病患儿200例的临床资料。结果本组患儿手术均顺利完成，手术死亡2例，与同期首次正中开胸手术死亡率比较无显著差异。年龄0.6～16.8（5±3）岁，体质量5～112（18±10）kg，体外循环时间37～442（143±64）min，主动脉阻断时间21～222（89±41）min。发生重大损伤7例，本亚组无手术死亡。结论再次开胸手术治疗先天性心脏病相对安全。开胸过程中发生的重大损伤不增加患儿的手术死亡率。

AIM To analyze the surgical technique and clinical results of repeat stemotomy in pediatric cardiac surgery. METHODS Clinical data of 200 repeat median stemotomies from January 2012 -Jan- uary 2014 in our pediatric cardiac center were analyzed retrospectively. RESULTS Surgical procedures for the 200 cases were all completed and operative mortality occurred in two patients. Median age and weight were, respectively, 5.2 （0. 6 - 16. 8） years and 18.1 （5 - 112） kg. Time for cardiopulmonary bypass and aortic clamp was, respectively, 142. 6 （37 -442） min and 89. 2 （21 -222） min. There were seven major injuries and no deaths in the subgroup. No statistical difference was found in the operative mortality major injury group and no major injury group. CONCLUSION Repeat sternotomy in pediatric cardiac surgeries is relatively safe. Major injury during repeat sternotomy is not associated with increased risk of operative mortality.