经右腋下直切口体外循环低温室颤下行心内直视手术38例  

Results of 38 cases with heart surgery under hypothermic ventricular fibrillation during cardiopulmonary bypass through the right axillary straight incisionResults of 38 cases with heart surgery under hypothermic ventricular fibrillation during cardiopulmonary bypass through the right axillary straight incision

作　　者：周新明[1] 李伦明[1] 梁湘源[1] 张志刚[1] 王广阔[1] 邓毅权[1] 

机构地区：[1]江门市中心医院心血管外科,广东省529030

出　　处：《中国心血管病研究》2011年第4期284-286,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的总结经右腋下直切口体外循环低温室颤下行心内直视手术的治疗结果，探讨本术式的适应证及禁忌证。方法以2006年6月至2010年12月，经右腋下直切口体外循环低温室颤下行心内直视手术的38例患者为试验组，其中单纯房间隔缺损21例、室间隔缺损13例、二尖瓣置换4例；以同期经胸骨正中切口行体外循环下低温停跳心内直视手术的165例患者为对照组。观察两组体外循环时间、术后12h血清肌钙蛋白T、辅助通气时间、输血量、住院时间、住院费用等指标，并进行比较。结果两组患者术后生存率差异无统计学意义。低温室颤组患者体外循环时间稍长于对照组，但术后12h血清肌钙蛋白T低于对照组，辅助通气时间两组差异无统计学意义，输血量、住院时间、住院费用低温室颤组均低于对照组。结论经右腋下直切口体外循环低温室颤下行心内直视手术安全，与传统手术方法相比，具有出血少、住院时间短等优点，在严格掌握适应证的情况下，值得临床推广。Objective To summarize the results of heart surgery under hypothermic ventricular fibrillation during cardiopulmonary bypass through the right axillary straight incision. Methods The experimental group was composed by 38 patients underwent heart surgery under hypothermic ventricular fibrillation during cardiopulmonary bypass through the right axillary straight incision the control group was composed by 165 patients underwent heart surgery under general surgical methods. Observation different of cardiopulmonary bypass time, serum troponin T 12 hours after, assisted ventilation, blood transfusion, hospital stay and costs between two groups. Results There was no difference in survival rates between two groups. Experimental group patients took longer CPB time, but the time to stay in the hospital, the costs in hospital were less than the control group of patients. Conclusion Heart surgery under hypothermic ventricular fibrillation during cardiopulmonary bypass through the right axillary straight incision is safe and effective, and select the appropriate patients is a key factor.

关 键 词：心脏手术 右腋下直切口 低温室颤 体外循环 

分 类 号：R654.2[医药卫生—外科学] R654.1[医药卫生—临床医学]