经右胸前外侧小切口行体外循环心内直视手术的治疗体会  

Summary of intracardiac operation under CPB through right anterolateral minithoracotomy incision

作　　者：付勇 廖斌 邓明彬 李新 于风旭 Fu Yong Liao Bin Deng Mingbin Li Xin Yu Fengxu(Department of Thoracic and Cardiovascular Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, 646000, Chin)

机构地区：[1]西南医科大学附属医院胸心外科,四川泸州646000

出　　处：《泸州医学院学报》2016年第6期512-515,共4页Journal of Luzhou Medical College

摘　　要：目的:采用右胸前外侧小切口行体外循环手术,探讨该手术方式的治疗效果。方法:经右胸前外侧小切口行体外循环手术患者22例(右侧开胸组),和胸骨正中切口行体外循环手术22例(正中开胸组),两组患者临床资料进行对比、分析,探讨经右胸前外侧小切口手术方式较传统手术方式的优、缺点。结果:右侧开胸组与正中开胸组一般临床资料比较差异无统计学意义;右侧开胸组较正中开胸组主动脉阻断时间、转机时间差异无统计学意义;右侧开胸组手术时间较正中开胸组长,术后总引流量前者较后者少,住院时间前者较后者短;右侧开胸组术后并发右肺挫伤率与正中开胸组比较差异有统计学意义;术后并发胸腔积液、心包积液及二次开胸率两组比较差异无统计学意义;心功能随访两组无统计学意义。结论:经右胸前外侧小切口体外循环手术存在切口小,美观,无金属异物存留等优点,但手术操作难度较大,应注意术后肺挫伤、心包积液、胸腔积液等并发症的发生。Objective： To evaluate the effect of intracardiac operation under CPB through right anterolateral minithoracotomy （RAMT） and summarize our experience. Methods： Fourty four cases were divided evenly into CPB through RAMT （ right thoracotomy group） and CPB through median sternotomy groups. The advantages and disadvantages of the two groups were compared by analyzing their clinical data. Result： There were no differences in the demographic information, the aortic cross-clamping time and CBP time between the two groups. However, compared to median thoracotomy, right thoracotomy had significantly shorter operation time, less postoperative drainage, and decreased hospital stay. There were no differences in the rates of right lung contusion, pleural effusion, pericardial effusion and reoperation between the two groups. Cardiac functions in the follow-up were no different as well. Gonelusion： There were advantages such as small wounds, beautiful incision and non-metallic foreign bodies under CPB through RAMI, however this operation is more difficulty, and is associated with pulmonary contusion, pericardial effusion, pleural effusion and other complications.

关 键 词：体外循环 微创心脏外科 右胸小切口 胸骨正中切口 

分 类 号：R654.1[医药卫生—外科学] R654.2[医药卫生—临床医学]