胸骨下段小切口在低龄儿童简单先心病直视修补术中的应用  

Surgical Repair of Simple Congenital Heart Defects via a Lower Partial Sternotomy in Small Children

作　　者：邓喜成[1] 刘平波[1] 黄鹏[1] 罗金文[1] 杨小晖[1] 阳广贤[1] 

机构地区：[1]湖南省儿童医院心胸外科,湖南省长沙市410007

出　　处：《临床小儿外科杂志》2015年第2期121-123,共3页Journal of Clinical Pediatric Surgery

摘　　要：目的：报道经胸骨下段小切口修补房／室间隔缺损术式的应用经验。方法按以下标准分为两组：1.胸骨下段小切口组：2013年8月至2014年2月连续房／室间隔缺损患者32例，均经胸骨下段小切口在心脏停跳下修补房／室间隔缺损；2.常规开胸组：2012年2月至2014年2月近两年行常规开胸房／室缺手术113例，使用倾向性评分方法选出32例，使其年龄、体重、性别比例及缺损大小、主要手术类型与胸骨下段小切口组相仿，均行常规胸骨正中劈开切口，在心脏停跳下进行修补手术。收集相关病历资料，比较两组的手术时间、体外循环时间、术后机械通气时间、术后引流量及术后住院天数。结果胸骨下段小切口组与常规开胸组相比，切口长度、术后机械通气时间及术后24 h 引流量显著短于后者而手术时间、ICU 停留时间及术后住院天数无显著差异。结论经胸骨下段小切口修补房／室间隔缺损是一种安全、可靠、美观、恢复快且疼痛小的微创手术方法。Objective To report our experience with atrial septal defect repair via a lower partial sterno-tomy. Methods A retrospective clinical study was conducted between two groups.Lower partial sternotomy group：a consecutive series of 32 cases of atrial/ventricular septal defect were repaired via a lower partial sterno-tomy.Conventional sternotomy group：113 consecutive cases with atrial/ventricular septal defect surgically trea-ted over the last two years at our institution were reviewed.A propensity score matching method was carried out and 32 cases matching the first group were selected with comparable age,weight and sex.All the patients in this group were operated on through a full sternotomy and the defect was repaired with the heart arres-ted.Comparison was made between the two groups with regard to operative time,CPB time,ventilation time, drainage amount and postoperative hospital stay. Results Patients in the lower partial sternotomy group had shorter incision length,ventilation time,drainage amount within 24 hours yet were not different from those in the other group in operation time and postoperative hospital stay. Conclusions Atrial/ventricular septal defect re-pair via a lower partial sternotomy in babies and toddlers is a safe,reliable,cosmetic minimally invasive ap-proach with faster recovery and less pain.

关 键 词：室间隔缺损/外科学 房间隔缺损/外科学 胸骨 儿童 

分 类 号：R654.2[医药卫生—外科学]