右腋下小切口与胸骨正中切口两种入路方式治疗先天性心脏病患儿的效果观察  

Clinical observations of right subaxillary small incision approach versus mid-sternal incision approach in the treatment of congenital heart disease

作　　者：李晓恒[1] 李燕平[2] 付晓可 李斌[1] LI Xiaoheng;LI Yanping;FU Xiaoke;LI Bin(Department of Cardiology,Luoyang Central Hospital,Luoyang Henan 471000,China;Department of Emergency,Luoyang Central Hospital,Luoyang Henan 471000,China)

机构地区：[1]洛阳市中心医院心外科,河南洛阳471000 [2]洛阳市中心医院急诊科,河南洛阳471000

出　　处：《临床研究》2024年第6期12-15,共4页Clinical Research

摘　　要：目的探讨先天性心脏病患者采取不同入路手术治疗的临床价值。方法抽取洛阳市中心医院2021年1月至2023年12月收入的先天性心脏病患儿70例,依据不同手术方式分为对照组与观察组,各35例,对照组接受胸骨正中切口,观察组接受右腋下小切口,对两组患儿临床指标(手术时间、体外循环时间、输血量、胸腔引流量、主动脉阻断时间、住院时间),疼痛程度,呼吸功能及并发症发生情况进行组间比较。结果两组患儿手术时间、体外循环时间、主动脉阻断时间相比,差异无统计学意义(P>0.05),观察组输血量、胸腔引流量均低于对照组,且住院时间短于对照组,差异有统计学意义(P<0.05);两组患儿各时间段呼吸功能指标相比,差异无统计学意义(P>0.05);观察组患儿各时间段疼痛程度评分均低于对照组,差异有统计学意义(P<0.05);两组患儿并发症发生风险相比,差异无统计学意义(P>0.05)。结论两种手术入路方式均可治疗先天性心脏病,且与胸骨正中切口相比,右腋下小切口不会影响患儿呼吸功能,且可改善疼痛程度,促进患儿快速康复,安全性较高,值得临床应用。Objective To explore the clinical values of different surgical approaches in the treatment of congenital heart disease.Methods From January 2021 to December 2023,70 cases of congenital heart disease patients were collected from Luoyang Central Hospital.Based on different surgical methods,they were divided into a control group and an observation group,each with 35 cases.The control group underwent median sternotomy,while the observation group underwent a small incision in the right axilla. Clinical indicators (surgical time, extracorporeal circulation time, blood transfusion volume, thoracic drainage volume, aortic occlusion time, hospital stay), pain level, respiratory function, and incidence of complications were compared between the two groups. Results There were no significant between-group differences about the operation time, extracorporeal circulation time and aortic crossclamp time (P > 0.05);the transfusion volume and thoracic drainage volume in the observation group were smaller than control group;the hospital stays were shorter than control group, with statistically significant difference (P < 0.05);There was no statistically significant difference in respiratory function indicators between the two groups of children at different time periods (P > 0.05);at each time period, the pain scores in the observation group were lower than control group, with statistically significant difference (P < 0.05);the surgical complication risks between groups were not significantly different (P > 0.05). Conclusion Both of the surgical approaches are proven to be effective. However, the right subaxillary small incision approach produces less impact on the children’s respiratory function, reduced the pain degrees, promotes the fast rehabilitation and increases the surgical safety for congenital heart disease children. It is worthy of clinical promotion.

关 键 词：先天性心脏病 心脏直视手术 右腋下小切口 胸骨正中切口 

分 类 号：R726.5[医药卫生—儿科]