右腋下小切口修补室间隔缺损手术58例

目的探讨右腋下小切口直视下行修补室间隔缺损手术的可行性及临床疗效。方法回顾性分析我院2008年3月到2012年3月收治的58例室间隔缺损患者的临床资料,所有患者均采用右腋下外侧第4肋间处进胸,体外循环下采取室间隔缺损修补手术。结果本组患者均痊愈出院,体外循环时间20～45 min,主动脉阻断时间0～30 min,术后心功能恢复较好,其中1例患者术后第2天出现一过性房室传导阻滞,1例患者发生Ⅲ度房室传导阻滞,2例发生活动性出血,3例右胸腔中等量积液,经治疗后均痊愈。其他患者未并发严重心律失常,无主动脉瓣和房室瓣返流,住院时间6～10d。结论经右腋下小切口直视下行修补室间隔缺损手术,具有操作简单、相对安全,有效减少室间隔缺损术后早期严重并发症的发生,恢复快、疼痛轻、近期临床疗好等特点。

Clinical Analysis of 58 Cases about Right Subaxillary Small Incision Repair of Ventricular Septal Defect Operation

Objective To investigate the right axillary incision to look straight down to the feasibility and clinical efficacy of repair of ventricular septal defect surgery.Method Retrospective analysis of 58 cases admitted to our hospital from March 2008 to March 2012,clinical data of patients with ventricular septal defect,all patients were treated at four intercostal of the right axillary lateral thoracotomy,without cardiopulmonary bypass,take the ventricular septal defectsurgical repair.Result This group of patients were discharged 20 to 45 min of cardiopulmonary bypass time,aortic cross-clamping time 0~30 min,recovery of cardiac function better,including two days of the patients were transient atrioventricular conduction resistancestagnation,one patient ⅲ degree atrioventricular block,and two cases of active bleeding,three cases of medium amount of right pleural effusion,were cured after treatment.Other patients with no complication of severe arrhythmia,aortic valve and atrioventricular valve regurgitation,6 to 10 days of hospital stay.Conclusion The right axillary incision look straight down the repair of ventricular septal defect surgery,simple operation,relatively safe and effective in reducing the occurrence of early postoperative severe complications of ventricular septal defect and restore the light,pain,and recent clinical treatment.