右腋下切口手术与胸骨正中切口手术治疗儿童先天性心脏病效果研究  

Clinical treatment effects of Congenital Heart Defects in Children by comparing the surgical methods between Right Subaxillary and Median Sternotomy

作　　者：张晶洁[1] 

机构地区：[1]重庆医科大学附属儿童医院手麻科,儿童发育和疾病研究教育部重点实验室,重庆400014

出　　处：《吉林医学》2015年第17期3741-3743,共3页Jilin Medical Journal

基　　金：2013~2014年度国家临床重点专科建设项目项目编号:国卫办医函[2013]544号

摘　　要：目的:对儿童先天性心脏病右腋下垂直切口手术与胸骨正中切口手术的临床治疗效果进行研究,探讨两种手术方法的优劣,从而提高儿童先天性心脏病手术治疗效果。方法:随机将儿童先天性心脏病手术治疗的患者分为两组:右腋下切口组27例,胸骨正中切口组30例,对两组手术方法在手术中主动脉阻断时间(ACC)、体外循环(CPB)时间、术中出血、手术时间、监护室(ICU)滞留时间、术后呼吸机辅助通气时间、术后引流量、术后引流管拨管时间、术后并发症、术后住院天数及术后抗生素使用等指标进行比较。结果:右腋下切口组比胸骨正中切口组手术时间长,在ICU滞留时间短,差异有统计学意义(P﹤0.05),术后引流管拨管时间短、引流量少、术后抗生素使用少,差异有统计学意义(P﹤0.01)。两组在手术中ACC、CPB、术中出血、术后呼吸机辅助通气时间、术后并发症、术后住院天数,差异无统计学意义(P﹥0.05)。结论:右腋下切口组,术后切口创伤小,美观,对于手术患儿成长过程的心理影响少,优于胸骨正中切口组治疗简单的儿童先天性心脏病。Objective To improve the clinical treatment effects of Congenital Heart Defects in Children by comparing the surgical methods between Right Subaxillary and Median Sternotomy. Method The patients were randomly divided into two groups： Right Subaxillary group（ 27 cases） and Median Sternotomy one（ 30 cases）. To compare the indexes such as aorta cross-clamping time,cardiopulmonary bypass time,intraoperative bleeding,time of operation,intensive care unit residence time,postoperative respirator assisted ventilation time,postoperative drainage volume,time for pulling out postoperative drainage tube、postoperative hospital stay and use of postoperative antibiotics. Results We found that the operation time in Right Subaxillary group was longer than that in Median Sternotomy. The time of intensive care unit residence in Right Subaxillary was shorter than that in Median Sternotomy group,the difference was statistically significant（ P〈0. 05）. The time for pulling out postoperative drainage tube in Right Subaxillary was shorter than that in Median Sternotomy group,the difference was statistically significant（ P〈0. 01）. The postoperative volume of drainage and the use of postoperative antibiotics in Right Subaxillary were less than that in Median Sternotomy,the difference was statistically significant（ P〈0. 01）. It was unconspicuous find the differences between the aorta cross-clamping time,cardiopulmonary bypass time,intraoperative bleeding,postoperative complications,postoperative respirator assisted ventilation time and the postoperative hospital stay in two ways,the difference wasn＇t statistically significant（ P〉0. 05）. Conclusion The advantages of Right Subaxillary are small incision,tiny operational trauma,good appearance,less influence on the growing process of children. The clinical treatment effect of Right Subaxillary is much better than Median Sternotomy of Congenital Heart Defects in Children.

关 键 词：右腋下切口 正中切口 先天性心脏病 儿童 

分 类 号：R726.5[医药卫生—儿科]