右腋下小切口房、室间隔缺损修补术在成人中的临床研究  

Clinical research of open heart surgery by right subaxillary small incision in the adult of congenital heart disease.

作　　者：宁玉林[1] 赵国强[1] 张永辉[1] 孙小润[1] 

机构地区：[1]河南省焦作市第二人民医院心脏外科,454100

出　　处：《中国医药》2007年第3期143-145,共3页China Medicine

摘　　要：目的 对比右腋下小切口手术与胸骨正中切口手术治疗成人房间隔缺损、室间隔缺损的临床价值。方法 我院1999年1月至2005年5月84例成年房间隔缺损、室间隔缺损患者，随机分为经右腋下小切口组及正中胸骨劈开组并进行比较分析。观察主动脉阻断时间、关胸时间、住院时间、术后气管插管带管时间、胸腔引流量、出血量、疼痛分级、镇痛药物用量。结果 42例患者全部经右腋下小切口顺利完成心内直视手术。平均主动脉阻断时间、气管插管带管时间、住院时间与正中胸骨劈开组比较差异无显著性（P〉0．05）；平均关胸时间、疼痛分级、镇痛药物使用量、术后胸腔引流量、出血量与正中胸骨劈开组比较差异有显著性（P〈0．05）。结论 右腋下小切口心内直视手术对成人房、室间隔缺损患者应用良好且与胸骨正中切口直视手术相比，有切口小、创伤小、出血少、疼痛轻、恢复快、瘢痕小且隐蔽性好等优点，患者易于接受。Objective To evaluate the clinical value of open heart surgery by right subaxillary small incision compared to midsternal incision in the treatment of atrial septal defect or ventricular septal defect of adults. Methods Eighty-four patients with atrial septal defects or ventricular septal defects since January 1999 to May 2005 were randomly divided into two groups. Experimental group was performed on right subaxillary and control group was performed on conventional mid-sternal incision. The following indices were compared between these two groups such as time of aorta blocking, time of stitch thorax, preserving time of trachea intubator, drainage volume after operation, haemorrhage volume,aching grade, quantity of ease pain medicine and hospitalization days. Results There was a significant difference in time of aorta blocking, drainage volume after operation, haemorrhage volume, aching grade and quantity of Ease pain medicine between two groups （ P 〈 0.05 ）. And there was no siginificant difference in other indicies between two groups （ P 〉 0.05 ）. Conclusion It is good that open heart surgery by right subaxillary small incision is useful for atrial septal defects or ventricular septal defects of adults. It is advantageous that open heart surgery by right subaxillary small incision not only shortens incision, wound, bleeding but also can diminish aching, haemorrhage volume, scar and during operation in the treatment of congenital heart disease, and it is easy to be accepted by patient.

关 键 词：先天性心脏病 微创外科技术 心脏外科手术 

分 类 号：R541.1[医药卫生—心血管疾病]