食道超声协助下经右胸小切口与胸骨正中切口治疗室间隔缺损的疗效  

Efficacy of esophageal ultrasound-assisted lower right thoracic small incision and sternal midline incision in treating the ventricular septal defect

作　　者：彭俊佳 王吉祥 余淑华 PENG Junjia;WANG Jixiang;YU Shuhua(Department of Cardiothoracic Surgery,Fifth People's Hospital of Shangrao City in Jiangxi Province,Shangrao 334000,China)

机构地区：[1]江西省上饶市第五人民医院心胸外科,江西上饶334000

出　　处：《中国现代医生》2021年第34期52-55,共4页China Modern Doctor

摘　　要：目的探讨在食道超声协助下经右胸小切口完成室间隔缺损修补术与传统胸骨正中切口治疗室间隔缺损的疗效。方法选取2015年6月至2019年12月在我院行食道超声心动图辅助下经右胸小切口室间隔缺损修补术的45例室间隔缺损患者为研究组,经正中切口进行室间隔缺损修补术的32例室间隔缺损患者为对照组。比较术后并发症发生率及心功能恢复指标,评估两种手术方式的治疗效果。结果两组均未发生低心排综合征、二次开胸止血、死亡、残余漏,差异无统计学意义(P>0.05);研究组未发现鸡胸,对照组发生3例,差异有统计学意义(P<0.05);研究组和对照组的血管药物使用时间及手术时间[(12.2±1.3)h,(123.3±12.6)min;(13.3±3.2)h,(126.6±13.6)min]比较,差异无统计学意义(P>0.05);研究组和对照组术后引流量及下床活动时间[(192.2±30.5)mL,(1.2±0.5)d;(258.8±37.5)mL,(2.2±0.8)d]、肺部感染发生率(4.4%、9.3%)比较,差异均有统计学意义(P<0.05)。结论该手术方式效果确切,较传统手术切口小、创伤小、痛苦小、患者恢复快。Objective To explore and compare the effect of the small right chest incision with the assistance of esophageal ultrasound and traditional median sternal incision in the treatment of the ventricular septal defect.Methods From June 2015 to December 2019 in our hospital,45 patients with ventricular septal defect repaired through a small right chest incision assisted by esophageal echocardiography were selected as the study group.Thirty-two patients with ventricular septal defect who underwent ventricular septal ischemia repair through a median incision served as the control group.The postoperative complication rate and the index of heart function recovery were compared to evaluate the therapeutic effect of the two surgical methods.Results No low cardiac output syndrome,secondary thoracotomy to stop bleeding,death,or residual leakage occurred in the two groups,the difference was not statistically significant(P>0.05);No pectus carinatum was found in the study group,3 cases occurred in the control group,and the difference was significant(P<0.05);There was no significant difference in the use time of vascular drugs and operation time[(12.2±1.3)h,(123.3±12.6)min;(13.3±3.2)h,(126.6±13.6)min]between the study group and the control group(P>0.05).There are significant statistical differences in postoperative drainage and time of getting out of bed[(192.2±30.5)mL,(1.2±0.5)d;(258.8±37.5)mL,(2.2±0.8)d],the incidence of lung infection(4.4%,9.3%)in the study group and control group(P<0.05).Conclusion This surgical method is effective,with a smaller incision,less trauma,and less pain than traditional surgical methods,and the patient recovers quickly.

关 键 词：经食道超声心动图 室间隔缺损 右胸小切口 术后并发症 

分 类 号：R654.2[医药卫生—外科学]