用右侧腋下小切口直视手术治疗小儿先天性心脏病的效果分析

Analysis of the effect of the right underarm small incision in the treatment of congenital heart disease in children

目的:探析用右侧腋下小切口直视手术治疗小儿先天性心脏病的临床效果及安全性。方法:将无锡市儿童医院2017年5月至2021年3月收治的66例先天性心脏病患儿作为研究对象。根据治疗术式的不同将其分为常规组和右侧组。对常规组33例患儿实施胸骨正中切口手术,对右侧组33例患儿实施右侧腋下小切口直视手术,然后对比两组患儿的手术时间、体外循环时间、主动脉阻断时间、胸腔引流量、输血量、术后辅助通气时间、术后体征监护时间、住院时间和术后并发症的发生情况。结果:1)右侧组患儿术后并发症的发生率低于常规组患儿,差异有统计学意义(P<0.05)。2)右侧组患儿的胸腔引流量、输血量均少于常规组患儿,其术后辅助通气时间、术后体征监护时间、住院时间均短于常规组患儿,差异有统计学意义(P<0.05)。3)两组患儿的手术时间、体外循环时间、主动脉阻断时间相比,差异无统计学意义(P>0.05)。结论:用右侧腋下小切口直视手术治疗小儿先天性心脏病的效果较好,具有创伤小、患儿术后恢复快、安全性高等优点。

Objective:To explore the clinical effect and safety of the treatment of congenital heart disease with the right underarm incision.Methods:A total of 66 children with congenital heart disease admitted to Wuxi Children’s Hospital from May 2017 to March 2021 were selected as the study subjects.According to the different surgical methods,they were divided into conventional group and right group.Regular group of 33 cases of children with sternum midline incision surgery,for the right group of 33 cases of right subaxillary small incision surgery,and then compare the two groups of children with surgical time,extracorporeal circulation time,aorta blocking time,chest,blood transfusion volume,postoperative drain assisted ventilation time,postoperative symptoms monitoring time,length of hospital stay and postoperative complications.Results:1)The incidence of postoperative complications in the right group was lower than that in the conventional group,the difference was statistically significant(P<0.05).2)The thoracic drainage volume and blood transfusion volume of the right group were less than those of the conventional group,and the postoperative auxiliary ventilation time,postoperative physical signs monitoring time and hospital stay were shorter than those of the conventional group,with statistically significant differences(P<0.05).3)There were no significant differences in operation time,CPB time and aorta blocking time between the two groups(P>0.05).Conclusion:The treatment of congenital heart disease with right axillary small incision is effective,with advantages of small trauma,quick postoperative recovery and high safety.