经右腋下小切口与胸骨正中切口手术治疗先天性心脏病的效果

目的 分析胸骨正中切口术与经右腋下小切口治疗先天性心脏病（CHD）的效果。方法 选取2018年1月~2019年1月我院收治的92例CHD患儿资料，随机分为研究组和对照组，每组46例。研究组采用经右腋下小切口治疗，对照组采用胸骨正中切口术治疗，比较两组术中指标（体外循环、主动脉阻断、手术时间及术中出血量）、术后指标（抗生素运用次数、术后引流量、置引流管时间、滞留ICU时间）及术后并发症。结果 两组术中出血量、体外循环时间、主动脉阻断时间对比，差异无统计学意义（P＞0.05）；对照组手术时间短于研究组［（2.33±0.39）h vs （2.75±0.40）h］，差异具有统计学意义（P＜0.05）。研究组抗生素运用次数和术后引流量均少于对照组，置引流管时间和滞留ICU时间均短于对照组，差异具有统计学意义（P＜0.05）。研究组术后并发症总发生率低于对照组（0 vs 15.21%），差异具有统计学意义（P＜0.05）。结论 CHD患儿接受经右腋下小切口术医治损伤轻微，能减少并发症发生，加快术后恢复。

The Effect of Surgical Treatment of Congenital Heart Disease through Small Incision ofRight Inferior Tibia and Median Sternotomy

Abstract:Objective To analyze the effect of median sternotomy and small incision in the right axilla on congenital heart disease (CHD).Methods The data of 92 children with CHD admitted to our hospital from January 2018 to January 2019 were randomly divided into study group and control group, with 46 cases in each group. The study group was treated with a small incision under the right inferior tibia, and the control group was treated with a mid-sternal incision. The intraoperative parameters (cardiopulmonary bypass, aortic occlusion, operative time and intraoperative blood loss) and postoperative indexes (antibiotic use) were compared between the two groups. The number of times, postoperative drainage, placement of the drainage tube, retention of ICU time) and postoperative complications.Results There was no significant difference in intraoperative blood loss, extracorporeal circulation time, and aortic occlusion time between the two groups (P>0.05). The operation time of the control group was shorter than that of the study group [(2.33±0.39)h vs (2.75±0.40) h], the difference was statistically significant (P<0.05). The number of antibiotics and postoperative drainage were lower in the study group than in the control group. The time of drainage tube and the retention time of ICU were shorter than those of the control group,the difference was statistically significant (P<0.05). The total incidence of postoperative complications in the study group was lower than that in the control group (0 vs 15.21%),the difference was statistically significant (P<0.05).Conclusion Children with CHD underwent a small incision through the right inferior tibiofibular approach to reduce the risk of complications and accelerate postoperative recovery.