摘要
目的探讨微创小切口联合心脏不停跳手术治疗儿童房间隔缺损的临床疗效。方法选取2018年1月—2020年3月上海交通大学医学院附属新华医院儿心脏中心收治的采用微创小切口联合心脏不停跳手术方法治疗的房间隔缺损患儿69例,观察患儿临床特征、围术期各项指标及术后随访情况并评估临床疗效。结果右腋下小切口手术51例,正中小切口手术18例,所有患儿手术均获得成功,其中中位呼吸机使用时间5(2~51)h,中位ICU监护时间1(1~7)d,中位胸腔引流3(2~5)d,中位住院时间11(7~24)d,术后随访未见残余分流,心功能指标均正常;正中小切口手术患者心内其他畸形发生率高于右腋下小切口手术患者,且ICU监护时间、胸腔引流时间和住院天数长于右腋下小切口手术患者(P<0.05)。结论微创小切口联合心脏不停跳手术治疗可广泛运用于儿童房间隔缺损,针对不同情况选择右腋下或正中小切口手术均能达到满意的临床疗效。
Objective To investigate the clinical effect of pediatric atrial septal defect repair with minimally invasive incision and beating-heart surgery.Methods 69 atrial septal defect repair on minimally invasive incision and beating-heart surgery were accomplished Pediatric Heart Center,Xinhua Hosptial Affiliated to Shanghai Jiaotong University School of Medicine from January 2018 to March 2020.Clinical characteristics,perioperative data and postoperative follow-up were observed and clinical effect were evaluated.Results All patients were sucessfully operated,including 51 patients with right minimal axillary incision and 18 patients with minimal sternal incision.Durations of ventilator support,ICU stay,chest tube drainage and total hospitalization were 5(2-51)hours,1(1-7)days,3(2-5)days and 11(7-24)days respectively.Residual shunt was not found and cardiac function was normal during the follow-up.Compared with subgroup of right minimal axillary incision,there were highr incidence of intracardiac anomalies in patients with minimal sternal incision whose durations of ICU stay,chest tube drainage and total hospitalization were significantly prolonged(P<0.05).Conclusion Atrial septal defect repair with minimally invasive incision and beating-heart surgery could be widely used in pediatric patients.Both right minimal axillary incision and minimal sternal incision may lead to satisfactory results under different circumstance.
作者
刘巍
彭永宣
白凯
唐嘉忠
鲁亚南
LIU Wei;PENG Yongxuan;BAI Kai;TANG Jiazhong;LU Yanan(Pediatric Heart Center,Xinhua Hosptial Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)
出处
《实用心脑肺血管病杂志》
2020年第S02期68-70,共3页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
2018年上海交通大学“医学转化交叉基金”(ZH2018ZDA10)
