经右腋下切口封堵先天性室(房)间隔缺损的可行性研究  

Feasibility of Blocking Congenital Ventricular Septal Defect or Congenital Atrial Septal Defect through Right Subaxillary Incision

作　　者：杭永斌 李刚 王树伟 杨巧玲 徐彦斌 梁强 刘洁 

机构地区：[1]解放军153中心医院心血管外科,郑州450007

出　　处：《中国胸心血管外科临床杂志》2016年第8期796-799,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的 探讨右腋下小直切口行先天性室（房） 间隔缺损封堵术的可行性和安全性。方法 回顾性分析2015年1 ～ 8月在我院行室（房）间隔缺损封堵术患者38例的临床资料，其中男22例、女16例，年龄（10.3±5.2） 个月，体重（8.2±3.5） kg。结果 34例（89.5%） 患者经右腋下小直切口封堵成功，术中失血量（19.5±13.4） ml，封堵手术时间（58.4±28.5） min。有4例（10.5%）室间隔缺损患者，因主动脉瓣脱垂，封堵未成功，改为全身麻醉体外循环下直视修补。术中未发生其他严重不良事件。术后拔管时间（3.9±1.6） h，术后ICU留置时间（1.8±0.8） d，住院时间（3.2±0.5） d。所有患者均顺利出院。结论 经右腋下切口行先天性室（房）间隔缺损封堵术是一种可行、有效、微创、安全的治疗方法，其早期随访结果良好。Objective To evaluate the feasibility and safety of blocking congenital ventricular septal defect or congenital atrial septal defect through the small vertical incision of right subaxillary. Methods We retrospectively analyzed the clinical data of 38 patients underwent the surgery of blocking congenital ventricular septal defect or congenital atrial septal defect in our hospital from January to August 2015. There were 22 males and 16 females with a mean age of 10.3±5.2 months, weight of 8.2±3.5 kg. Results There were 34 patients （89.5%） successfully blocked through the small vertical cut of right subaxillary. The average blood loss of those 34 patients was 19.5±13.4 ml and the mean time of surgery was 58.4±28.5 minutes. Four patients （10.5%） with ventricular septal defect failed to block because of aortic valve prolapse. Those patients underwent direct repair of ventricular septal defect under extracorporeal circulation while general anesthesia. There was no serious adverse event during the surgery. The extubation time was 3.9±1.6 hours, the ICU monitoring time was 1.8±0.8 days and the hospital stay time was 3.2±0.5 days. All patients discharged uneventfully. Conclusion Blocking congenital ventricular septal defect or congenital atrial septal defect through the cut of right subaxillary is a feasible, effective, safe, and minimally invasive method. The effect of early follow-up is well.

关 键 词：室(房)间隔缺损 经胸微创封堵术 右腋下切口 经食管超声心动图 

分 类 号：R726.5[医药卫生—儿科]