经右外侧小切口与正中剖胸切口矫治房间隔与室间隔缺损的对比研究  

Comparisons of the short right lateral thoracotomy to the median sternotomy for correction of ASD and VSD

作　　者：钟锋[1] 何家贤[1] 陈桂荣[1] 黄俊[1] 

机构地区：[1]梧州市红十字会医院胸心外科,广西梧州543002

出　　处：《岭南心血管病杂志》2009年第5期370-371,383,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的评价经右外侧小切口矫治房间隔与室间隔缺损手术的优点。方法回顾性分析经右外侧切口48例患者(右外侧切口组)和正中切口56例患者(正中剖胸切口组)矫治房间隔与室间隔缺损手术的结果、主要并发症及随访资料,并进行比较。结果两组患者的体外循环时间、心肌循环阻断时间、术后机械通气时间、术后住院时间比较,差异无统计学意义(P>0.05);两组均无死亡;术后胸液量右外侧切口组为(103.6±58.3)mL,正中剖胸切口组为(153.1±63.5)mL,两组比较差异统计学意义(P<0.05);随访(60.1±16.3)个月,右外侧切口组无并发鸡胸,正中剖胸切口组有1例并发鸡胸。结论经右外侧小切口矫治房间隔与室间隔缺损安全、有效,与正中剖胸切口手术相比具有创伤小、出血少、瘢痕隐蔽、不破坏胸廓的骨性连续性等优点。Objectives To evaluate the advantages of the short right lateral thoracotomy for correction of ventricular septal defect ( VSD) and atrial septal defect ( ASD) compared to the median sternotomy. Methods Forty eight patients [(5.1±2.3) years] with VSD or ASD received a right thoracotomy were included in the case group, while 56 patients [( 5.8 ±2.6) years] with VSD or ASD received a median sternotomy were included in the control group. Cardiopulmonary bypass, arotic cross-clamping and mechanical ventilation time, volume of drainage, the days of postoperative hospitalization, and in-hospital mortality and morbidity were recorded as short-term outcomes. The median duration of follow-up was ( 60.1 ±16.3) months. Results There were no difference in time of cardiopulmonary bypass, aortic aross-clamping and mechanical ventilation, the days of postoperative hospitalization, and in-hospital mortality and morbidity. However, the volume of drainage in case group was less than that in control group [(103.6± 58.3) mL vs. (153.1±63.5) mL, P<0.05]. One pigeon chest was observed in control group, while none in case group ( 0 versus 1). Conclusions The short right lateral thoracotomy for repairing VSD or ASD may achieve a satisfied outcomes compared to the median sternotomy.

关 键 词：房间隔缺损 室间隔缺损 外科手术 

分 类 号：R541.1[医药卫生—心血管疾病]