右腋下小切口及正中开胸在房间隔缺损修补术中的效果对比

Comparison of effects of right subaxillary small incision and thoracic midline thoracotomy in repairing atrial septal defect

目的比较右侧腋下小切口和胸部正中开胸两种术式在治疗先天性心脏病继发孔房间隔缺损中的效果。方法选取2018年6月-2021年6月因继发孔房间隔缺损不适宜行介入封堵术于本院接受房间隔缺损修补术的患者80例,术前患者均无明显心衰症状,其中40例经右侧腋下小切口手术为实验组,40例经胸部正中开胸手术为对照组,术后比较两种术式的临床治疗效果。结果经右腋下小切口组手术时间、术中、术后总输血量、术后呼吸机辅助通气时间、住监护室时间、术后住院时间和并发症发生率均优于胸部正中开胸组,差异均有统计学意义(P<0.05)。结论与胸部正中开胸相比右侧腋下小切口手术在治疗房间隔缺损中手术时间短、术中、术后总输血量少、术后呼吸机辅助通气时间短、住监护室时间短、术后住院时间短和术后并发症发生率低。

Objective To compare the efficacy of right subaxillary small incision and thoracic midline thoracotomy in the treatment of secundum atrial septal defect of congenital heart disease.Methods A total of 80 patients receiving atrial septal defect repair due to secundum atrial septal defect unsuitable for interventional closure in our hospital from June 2018 to June 2021 were selected.None of the patients had obvious symptoms of heart failure before surgery,including 40 cases underwent right subaxillary small incision for the experimental group and 40 cases underwent thoracic midline thoracotomy for the control group.The clinical effects of the two methods were compared after operation.Results The operative time,total intraoperative and postoperative blood transfusion volume,postoperative ventilator-assisted ventilation time,stay time in ICU,postoperative hospital stay and incidence of complications in the right subaxillary small incision group were better than those in the thoracic midline thoracotomy group,there was statistical significance in the difference(P<0.05).Conclusions Compared with thoracic midline thoracotomy,the right subaxillary small incision in the treatment of atrial septal defect has shorter operative time,less intraoperative and postoperative total blood transfusion,shorter postoperative ventilator-assisted ventilation time,shorter stay in the ICU,shorter postoperative hospital stay and lower incidence of postoperative complications.