目的:探讨先天性心脏病(先心病)患儿行右侧腋下小切口直视手术临床应用效果.方法:把给予右侧腋下小切口直视手术的患者纳入研究组,行胸骨正中切口直视手术的患者纳入对照组.记录两组患儿手术情况、预后情况、随访结果.结果:研究组先心病患儿手术时间、辅助通气时间(术后)、引流量(术后24h)、住院时间(术后)均显著少于对照组(P<0.05);两组体外循环时间、主动脉阻断时间、术后不良反应发生率(分别为11.8%、8.2%)对比,差异无统计学意义(P>0.05);两组给予1年随访可知心功能均恢复正常(P>0.05),研究组“鸡胸”发生率显著低于对照组(21.2%,P <0.05).结论:先心病患儿经右侧腋下小切口直视手术治疗效果显著,有利于患儿尽快恢复健康并保障其生活质量.
Objective:To investigate the clinical effect of right vertical infra-axillary mini-incision on children with congenital heart disease Methods:A total of 170 children with congenital heart disease was enrolled in this study.The study group was given right vertical infra-axillary mini-incision surgery and the control group underwent median sternotomy incision surgery.The operation time,cardiopulmonary bypass time,aortic clamping time,postoperative auxiliary ventilation time,postoperative 24-h drainage flow and postoperative hospital stay were used to evaluate the effect of two operating methods.Results:Compared with the control group,the operation time,postoperative auxiliary ventilation time,postoperative 24-h drainage flow and postoperative hospital stay were shorter significantly in study group,in spite that cardiopulmonary bypass time,aortic clamping time were similar between two groups.In addition,the postoperative incidence of adverse reactions in study group was lower than the control group(respectively 8.2%,11.8 %),though there was no significant difference in comparison (P > 0.05).Furthermore;two-group patients were given 1 year follow-up,and all of them can resume normal heart function.However,the incidence of pectus carinatum in the study group (0.00%)was significantly lower than the control group (21.2%,P < 0.05).Conclusion:right vertical infra-axillary mini-incision surgical approach to simple congenital heart defects was a safe procedure and could be performed with excellent cosmetic and clinical outcomes.It provided a good alternative to the standard MSI for simple congenital heart defects.