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目的观察采用右腋下Denis Browne微创小切口径路对体外循环心内直视手术后肺顺应性的影响。方法64例先天性心脏病患者,按切口径路不同分为正中切口径路组和右腋下Denis Browne微创小切口径路组,每组各32例。均在体外循环下完成心内直视手术,在麻醉诱导后(T1)、关胸前(T2)、术后30 min(T3)、1 h(T4)、2 h(T5)5个时间点监测静态肺顺应性(Cs)和动态肺顺应性(Cd)变化。结果两组患者均在体外循环下完成心内直视手术,无手术死亡和严重并发症,术后恢复良好。两组患者Cs、Cd在关胸前(T2)比麻醉诱导后(T1)水平降低(P<0.05),术后30 min(T3)到达最低,直至术后2 h(T5)尚未恢复术前水平(P<0.05);组间比较,右腋下Denis Browne微创小切口径路组从关胸前(T2)开始均低于正中切口径路组(P<0.05)。结论采用右腋下DenisBrowne微创小切口使体外循环心内直视手术后胸肺顺应性下降。
Objective To observe the effect of right subaxillary Denis Browne minimally invasive small incision on lung compliance after open heart surgery under cardiopulmonary bypass. Methods Sixty-four patients with congenital heart disease were divided into two groups according to the diameter of incision: Denis Browne mini-incision group and right incision group, 32 cases in each group. All the patients underwent open heart surgery under cardiopulmonary bypass (CPP) under the conditions of induction of anesthesia (T1), chest closing (T2), 30 min (T3), 1 h (T4) and 2 h Static lung compliance (Cs) and dynamic lung compliance (Cd) were monitored. Results Both groups underwent open heart surgery under cardiopulmonary bypass. No operative death and serious complications were found, and postoperative recovery was satisfactory. The levels of Cs and Cd in the two groups were lower than those before induction (T1) (P <0.05), and reached the lowest level at 30 minutes (T3) after operation, but not until 2 hours (T5) (P <0.05). Compared between the two groups, Denis Browne mini-incision approach in the right axillary region was significantly lower than that in the middle incision approach group (P <0.05). Conclusion The right axillary DenisBrowne minimally invasive small incision cardiopulmonary bypass surgery after cardiopulmonary compliance decreased.