小儿先天性心脏病微创小切口治疗体会  

Experience of minimal incision in the treatment of congenital heart disease in children

作　　者：陈梦苒[1] 韩继彪[1] 邬松[1] 张俊峰[1] 韩浩[1] 张桂敏[2] 

机构地区：[1]解放军105医院心血管外科,安徽省合肥市230001 [2]昆明医科大学第一附属医院(云大医院)心血管外科

出　　处：《中国心血管病研究》2015年第1期82-84,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨胸骨下段小切口与右胸小切口两种微创术式在小儿常见先天性心脏病中的应用.方法 选取解放军105医院心血管外科2011年3月至2013年8月收治的先天性心脏病患儿63例,其中男性27例,女性36例.63例中采用胸骨下段小切口33例、右胸小切口30例;单纯房间隔缺损（ASD）22例,单纯室间隔缺损（VSD）25例,室间隔缺损合并动脉导管未闭（PDA）4例,室间隔缺损合并房间隔缺损10例,室间隔缺损合并肺动脉瓣狭窄（PS）2例.结果 所有患儿均顺利完成手术,无死亡,无低心排血量、肺部感染、切口感染等近期并发症.术后随访6个月至1年,无残余漏、Ⅲ度房室传导阻滞、胸廓畸形等远期并发症.结论 胸骨下段小切口与右胸小切口两种微创术式选择性应用于常见先天性心脏病,安全可靠、创伤小、切口美观,值得推广.Objective To explore the application for mini-sternotomy（lower half） and right mini-thoracotomy in the treatment of congenital heart disease in children. Methods From March 2011 to August 2013, 63 patients with congenital heart disease were underwent open heart surgery with cardiopulmonary bypass. 33 patients were operated by mini-sternotomy incision and 30 patients by right mini-thoracotomy incision. The cardiac defects includes 22 patients of atrial septal defect, 25 patients of ventricular septal defect, 4 patients of ventricular septal defect and patent ductus arteriosus, 10 patients of ventricular septal defect and atrial septal defect, 2 patients of ventricular septal defect and pulmonary stenosis. There were 27 male and 36 female patients. Results The operations were successfully performed with good exposure. There were no operative death, no short-term complications with low cardiac output, lung infection, incision infection. During the follow-up of 6-12 months, there were no long-term complications with residual shunt, Ⅲ°Atrioventricular block and thoracic deformity. Conclusion Both of mini-sternotomy and right mini-thoracotomy approaches can be done in selected common congenital heart disease, which are reliable, less traumas, good cosmetic effect and worthy of promotion.

关 键 词：胸骨下段小切口 右胸小切口 先天性心脏病 

分 类 号：R654.2[医药卫生—外科学]