文章摘要
张 涛,葛建军,张海洋,吴海波,焦海淼.右腋下小切口与胸骨正中切口入路手术治疗儿童简单先天性心脏病疗效比较的回顾性研究[J].,2022,(6):1056-1059
右腋下小切口与胸骨正中切口入路手术治疗儿童简单先天性心脏病疗效比较的回顾性研究
Retrospective Study on the Efficacy Comparison of Right Subaxillary Small Incision and Median Sternal Incision Approach in the Treatment of Simple Congenital Heart Disease in Children
投稿时间:2021-08-24  修订日期:2021-09-19
DOI:10.13241/j.cnki.pmb.2022.06.012
中文关键词: 儿童  先天性心脏病  胸骨正中切口  右腋下小切口  疗效
英文关键词: Children  Congenital heart disease  Median sternotomy  Right subaxillary small incision  Curative effect
基金项目:安徽省科技重大专项项目(18030801132)
作者单位E-mail
张 涛 中国科学技术大学附属第一医院(安徽省立医院)心脏大血管外科 安徽 合肥 230000 zt15855132898@163.com 
葛建军 中国科学技术大学附属第一医院(安徽省立医院)心脏大血管外科 安徽 合肥 230000  
张海洋 中国科学技术大学附属第一医院(安徽省立医院)心脏大血管外科 安徽 合肥 230000  
吴海波 中国科学技术大学附属第一医院(安徽省立医院)心脏大血管外科 安徽 合肥 230000  
焦海淼 中国科学技术大学附属第一医院(安徽省立医院)心脏大血管外科 安徽 合肥 230000  
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中文摘要:
      摘要 目的:对比右腋下小切口、胸骨正中切口入路手术治疗儿童简单先天性心脏病(CHD)的疗效。方法:回顾性分析2019年4月~2020年12月期间我院收治的简单CHD患儿100例的临床资料。根据不同的手术方法将接受胸骨正中切口入路的48例纳为A组,将接受右腋下小切口入路的52例纳为B组,观察两组患儿手术指标、术后恢复指标、瘢痕情况及术后并发症发生率。结果:两组患儿主动脉阻断、体外循环、手术时间对比无统计学差异(P>0.05),与A组相比,B组的术中失血量较少,组间对比差异有统计学意义(P<0.05)。与A组相比,B组住院费用、胸腔引流量均减少,术后辅助通气、监护及住院时间均明显缩短,组间对比差异有统计学意义(P<0.05)。B组血管分布、皮肤色泽、皮肤柔软、皮肤厚度的各维度评分及总分均低于A组(P<0.05)。两组患儿术后并发症发生率组间对比无统计学差异(P>0.05)。结论:右腋下小切口入路手术治疗简单CHD患儿,可获得与胸骨正中切口入路相当的治疗效果,同时还可减少术中出血量,促进患儿术后恢复,改善伤口瘢痕情况。
英文摘要:
      ABSTRACT Objective: To compare the efficacy of right subaxillary small incision and median sternal incision approach in the treatment of simple congenital heart disease (CHD) in children. Methods: The clinical data of 100 children with simple CHD who were treated in our hospital from April 2019 to December 2020 were retrospectively analysis. According to different surgical methods, 48 cases accepted the median sternal incision approach were included in group A, and 52 cases accepted the right subaxillary small incision approach were included in group B. The operation indexes, postoperative recovery indexes, scar condition and incidence of postoperative complications of the two groups were observed. Results: There were no significant differences in the aortic clamping, cardiopulmonary bypass and operation time between the two groups(P>0.05). Compared with group A, the intraoperative blood loss in group B was less, and the difference between groups was statistically significant(P<0.05). Compared with group A, the hospitalization expenses and chest drainage of group B were less, the postoperative ventilation, monitoring and hospitalization time were significantly shorter, and the difference between groups was statistically significant(P<0.05). The scores and total scores of blood vessel distribution, skin color, skin softness and skin thickness in group B were all lower than those in group A (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: The right subaxillary small incision in the treatment of children with simple CHD can obtain the same therapeutic effect as the median sternal incision approach, and it can reduce the intraoperative blood loss, promote the postoperative recovery of children, and improve the condition of wound scar.
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