摘要
目的评价心脏外科正中小切口对心脏手术部位的显露效果.方法在6具尸体上模拟正中小切口,对与心脏手术相关的诸结构进行观察.结果当切除第3肋软骨及其相连的部分胸骨时,上腔静脉、肺动脉、升高动脉显露效果最佳;当切除第4肋软骨及与其相连的部分胸骨的时候,除下腔静脉显露较差外,其余结构均可良好显露;当切除第5肋软骨及与其相连的部分胸骨时,主动脉瓣环、下腔静脉显露最佳.结论合理选择切口水平,经正中小切口可完成某些心脏手术.
Objective To evaluate the exposing effect of cardiac structures through minor median thoracotomy. Methods Minor median thoracotomy were imitated in six cadavers, and the structures that related to the cardiac surgery were observed. Results When the third costal cartilage and its connecting sternal segment were removed, superior vena cava, pulmonary artery, and ascending aorta could be exposed well. When the forth costal cartilage and its connecting sternal segment were removed, all the structures but inferior vena cava could be exposed well. When the third costal cartilage and its connecting sternal segment were removed, aortic valvular ring and inferior vena cava could be satisfactorily exposed. Conclusion Some cardiac operations could be accomplished through minor median thoracotomy if the position of the incision could be chosen rationally.
