正中小切口全胸骨劈开术应用于多数心脏手术策略

目的：探讨正中小切口全胸骨劈开术应用于多数心脏手术策略和实施技巧。方法：作者总结了个人近两年进行的302例全胸骨劈开正中小切口心脏直视手术经验；同时选取不同手术方式的二尖瓣修复手术进行手术效果、手术时间、主动脉阻断时间、出血量和ICU停留时间的比较。结果：正中小切口这种微创手术方式，将胸骨全切开，但将常规的20cm切口长度缩小到6～8cm，胸骨只撑开6cm，可以进行多数心脏手术，取得良好效果。适应症广泛，具备微创手术的切口小，美观的优点，对胸廓影响小，又具备正中开胸的心脏显露清楚，手术迅速确切，心脏中心插管，手术安全性高，不增加手术时间、主动脉阻断时间、出血量和ICU停留时间，不需要单肺通气等诸多优势。结论：正中小切口这种微创手术方式，适应症广泛，操作比较方便，尤其易于推广。

Progress in application of ministernotomy cardiac surgery

Objective: To investigate the strategies and implementation techniques of ministernotomy for most cardiac surgery. Methods: Summarized 302 cases of direct open-heart surgery with ministernotomy in the last two years, and compared them with other minimally invasive heart surgery with surgical effection, operation time, aortic occlusion time, bleeding volume and ICU stay time. Results: The ministernotomy completely cuts the sternum, but reduces the length of the conventional incision from 20cm to 6 or 8cm, and the sternum is only 6cm opened. It can perform most heart surgery with great results. It has a wide range of indications, smaller incisions and beautiful appearance, minimal impact on the thorax, and a heart with a mid-thoracotomy. The heart is clearly exposed, the operation is rapid and accurate, and no need for single lung ventilation. Conclusion: The ministernotomy has a wide range of indications and convenient operation, and it is especially easy to popularize.