经右腋下直切口与胸骨正中切口二尖瓣置换术比较  

Comparison of right axillary straight incision and median sternotomy in mitral valve replacement

作　　者：雷虹[1] 严中亚[1] 严宇[1] 章庆春[1] 

机构地区：[1]安徽省立医院心外科,合肥230001

出　　处：《安徽医学》2013年第9期1287-1289,共3页Anhui Medical Journal

摘　　要：目的比较经右腋下直切口和胸骨正中切口行二尖瓣置换术的效果。方法选择20例二尖瓣病变患者,分别行2种切口二尖瓣置换术,右腋下直切口10例,胸骨正中切口组10例。两组病例皆在体外循环下进行二尖瓣置换术。结果两组均无死亡病例。右腋下直切口体外循环建立时间比胸骨正中切口组长(P<0.05);右腋下直切口组输血量、术后24 h引流量均比胸骨正中切口组少(P<0.05);机械通气时间、ICU观察时间右腋下直切口组也比胸骨正中切口组少(P<0.05)。两组主动脉阻断时间、转流时间、总手术时间基本相同(P>0.05)。结论右腋下直切口行二尖瓣成形术具有良好的美观和临床效果,其微创和美观的优势给二尖瓣置换术提供了另一选择。Objective To compare the effect of right axillary straight incision and median sternotomy in mitral valve replacement. Methods Twenty patients undergoing mitral valve replacement under cardiopulmonary bypass were treated with two different operative ap- proaches ： 10 patients underwent right axillary straight incision and the other 10 patients underwent median sternotomy. Results There was no hospital death in each group. The time to establish cardiopulmonary bypass was longer in right axillary straight incision group （ P 〈 0.05 ）. The right axillary straight incision group had less chest drainage during the postoperative 24 hours than the median sternotomy group and re- quired less blood transfusion （ P 〈 0.05 ）. Postoperative mechanical ventilation time and Intensive Care Unit observation time were also less in the right axillary straight incision group （ P 〈 0.05 ）. There were no differences in aortic cross - clamp time, cardiopulmonary bypass time, and total operation time between the two groups （ P 〉 0.05 ）. Conclusion The right axillary straight incision can be performed with fa- vorable cosmetic and clinical results, which provides a good alternative to median sternotomy for mitral valve replacement.

关 键 词：右腋下直切口 胸骨正中口 二尖瓣置换术 微创外科 体外循环 

分 类 号：R654.2[医药卫生—外科学]