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目的探讨胸部正中小切口在婴幼儿先天性心脏病手术治疗中的可行性及效果。方法将我院2016年5月至2016年10月170例行手术治疗的常见先天性心脏病婴幼儿患者分为两组:常规组,85例,男42例、女43例,年龄(6.9±2.1)个月,采用常规胸部正中切口;小切口组,85例采用胸部正中小切口,男43例、女42例,年龄(6.4±1.8)个月。小切口手术切口于平第3肋间切开,止于剑突起始处上0.5 cm,刚好放入小胸骨撑开器为好。结果两组患儿体外循环时间差异无统计学意义(P>0.05)。小切口组手术时间略长(P<0.05)。两组预后没有差别,但是小切口组伤口长度显著缩短[(7.8±0.8)cm vs.(4.0±0.5)cm,P<0.05]。结论正中小切口基本具有胸骨正中切口的优点,可显露心脏各部位,满足绝大部分心脏探查和手术操作需要,必要时仍可向上延长切口使心内操作不受限制等优点,故认为正中小切口在婴幼儿心脏手术中具有良好的安全性和美观性。
Objective To investigate the feasibility and effect of median chest incision in the surgical treatment of congenital heart disease in infants. Methods From May 2016 to October 2016, 170 infants with common congenital heart disease undergoing surgery in our hospital from May 2016 to October 2016 were divided into two groups: conventional group, 85 cases, 42 males and 43 females, with an average age of 6.9 ± 2.1) months, the use of conventional chest incision; small incision group, 85 cases with a small incision in the middle of the chest, 43 males and 42 females, age (6.4 ± 1.8) months. Small incision surgical incision in the flat intercostal incision, ending at the beginning of the xiphoid 0.5 cm, just into the small sternal distraction device as well. Results There was no significant difference in CPB time between the two groups (P> 0.05). Small incision group operation time slightly longer (P <0.05). There was no difference in prognosis between the two groups, but the wound length in the mini-incision group was significantly shorter (7.8 ± 0.8 cm vs. 4.0 ± 0.5 cm, P 0.05). Conclusions The median incision has the advantages of median incision in the sternum and can reveal all parts of the heart to meet the needs of most cardiac exploration and surgical operations. If necessary, it can extend the incision upwards to make the intracardiac operation unrestricted. Therefore, Incision in infants and young children with cardiac surgery has good safety and aesthetics.