右腋下小切口在小儿心内直视手术的应用解剖及临床评价  

Right subaxillary small incision open heart surgery in children:Anatomical study and clinical evaluation

作　　者：游昕[1] 陈若为[1] 但文富[1] 赵六六[1] 周建国[1] 马游[1] 吴敏[1] 

机构地区：[1]南京解放军第454医院胸心外科,南京210002

出　　处：《中国微创外科杂志》2004年第3期187-188,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探讨右腋下小切口在小儿心内直视手术的解剖学基础及临床应用。　方法　 2 0 0 0年 9月～ 2 0 0 3年 9月我们采用右腋下小切口在体外循环下行心内直视手术 14例 ,测量皮肤切口、肋间切口、显露主动脉、肺动脉、右肺静脉及右心切口长度。　结果　皮肤切口、肋间切口、显露主动脉、肺动脉长度分别为 (5 6± 0 6 )cm、(7 4± 1 2 )cm、(2 1± 0 8)cm、(2 0±0 6 )cm。患儿全部恢复良好 ,无手术死亡及严重并发症。术后 2 4h胸腔引流 (12 0± 31)ml,术后住院 (8 4± 1 2 )d。患儿无胸骨畸形 ,切口疤痕小且隐蔽。　结论　右腋下小切口心内直视手术显露好 ,创伤小 ,术后恢复快 ,具有较好的美容效果且安全。Objective To investigate the anatomy and application of right subaxillary small incision open heart surgery in children. Methods We adopted right subaxillary small incision open heart surgery under extracorporeal circulation in 14 children from September 2000 to September 2003. The length of skin incision, intercostal incision, exposed aorta, exposed pulmonary artery, exposed right pulmonary vein and right heart incision were measured respectively. Results The length of skin incision, intercostal incision, exposed aorta and pulmonary artery were (5.6±0.6 ) cm, (7.4±1.2) cm, (2.1±0.8) cm, (2.0±0.6) cm, respectively. All the children recovered smoothly and no operative deaths or severe complications occurred. The chest drainage at 24 postoperative hours was (120±31) ml, and the postoperative hospital stay was (8.4±1.2) d. No sternal deformity was found in all the children and their incisions were slightly scarred. Conclusions Right subaxillary small incision open heart surgery is characterized by excellent visualization, minimal invasion, rapid recovery, good cosmetic results and safety.

关 键 词：小切口 心脏外科手术 解剖 小儿 

分 类 号：R726.5[医药卫生—儿科]