胸骨下段小切口心内直视手术40例  

Forty cases of limited lower sternotomy for open heart surgery

作　　者：王朝晖[1] 王鼎[1] 吴丹[1] 吴东信[1] 李卫国[1] 

机构地区：[1]锦州市中心医院心外科,辽宁省锦州市121004

出　　处：《中国心血管病研究》2005年第10期774-775,共2页Chinese Journal of Cardiovascular Research

摘　　要：目的介绍胸骨下段小切口心内直视手术体会。方法选择10岁以下房间隔缺损3例、室间隔缺损20例,纵劈胸骨上至第二肋间;10岁以上房间隔缺损5例、室间隔缺损3例、风湿性二尖瓣狭窄9例,纵劈胸骨上至第二肋间并向右侧横断。常规体外循环,胸正中小切口第三胸肋关节水平至剑突根部,完成心内直视手术。结果无手术死亡,平均主动脉阻断时间、体外循环时间、术后24h胸液量与对照组无明显差异。切口长度约为常规胸骨正中切口的60%。结论胸骨下段小切口可以顺利完成部分心内直视手术,美观且保留了胸廓的连续性,无胸骨前凸畸形。Objective To introduce experience of limited lower sternotomy for open heart surgery and report clinical results of 40 cases. Methods Stemotomy is the midline incision from the third rib to the base of xiphoid process. Patients under 10 years old underwent stemotomy to the second intercostal space, while patients over ten years old underwent stemotomy to the second intercostal space combining with right transverse cut of sternum. Operations were done by routine cardiopulmonary bypass （CPB）. Results There was no death report. There was also no significant difference in aortic cross-clamp time, CPB time and median blood loss of 24 hours after surgery between lower stemotomy group and control group. The length of incision was about 60% of routine median stemotomy. Conclusion Many open heart surgeries could be carried out through limited lower stemotomy, which has desirable cosmetic effect, continuity of the thoracic cage and no pigeon breast formation.

关 键 词：外科手术 最小侵入性 心脏/外科学 

分 类 号：R654.2[医药卫生—外科学]