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    find Keyword "胸骨下段小切口" 2 results
    • 改良胸骨下段小切口心瓣膜置換術

      目的 探討經改良胸骨下段小切口行心瓣膜置換術的適應證、手術方法和效果。 方法  81例心瓣膜病患者行二尖瓣置換術 4 0例 ,主動脈瓣置換術 18例 ,雙瓣膜置換術 2 3例 ,三尖瓣成形術 2 9例 ,左心房血栓清除 +左心耳內縫扎術 19例。二尖瓣置換術、主動脈瓣置換術和雙瓣膜置換術皮切口分別自第 4、第 3肋間水平至劍突根部 ,自下而上呈倒“J”形 ,縱行劈開胸骨分別至第 3、第 2肋間處向右側弧形橫斷胸骨。切口長度 7~ 13cm。 結果 全組無手術和術后死亡 ,發生并發癥 2例。主動脈阻斷時間、體外循環時間、手術時間和住院時間分別為 4 6 .0± 31.6分鐘、81.0± 4 7.8分鐘、3.4± 1.0小時和 8.0± 2 .3天。術后胸腔引流量 2 5 0± 2 2 2 ml,有 6 2例 (76 .5 % )患者未輸血。 73例隨訪 3個月~ 3年 ,所有置換的瓣膜位置和功能均正常 ,無瓣周漏。 結論 采用改良胸骨下段小切口行心瓣膜置換術安全可靠、美觀、創傷小、恢復快 ,并不延長手術時間 ,早期結果滿意。但須選擇合適的手術適應證 ,手術者具有較熟練的心內手術技術。

      Release date:2016-08-30 06:28 Export PDF Favorites Scan
    • Comparison of different thoracic incision approaches for congenital heart disease in children

      Objective To compare the clinical results of different thoracic incision approaches for congenital heart disease in children. Methods Retrospective analyses of the clinical results of different thoracic incision approaches for 1 669 children with congenital heart disease was performed. All patients were divided into median sternotomy group(Med group), right thoracotomy group (Rat group),and lower partial median sternotomy group (Pt group) according to different thoracic incision. Two hundred and forty five children underwent atrial septal defect(ASD) repair, 1 005 children underwent ventricular septal defect(VSD) repair and 419 children underwent tetralogy of Fallot(TOF) correct repair from Jan. 1999 to Dec. 2001. Results In ASD repair the incidence of pulmonary complications after operation in the Rat group was significantly higher than that in Med group and Pt group ( P lt;0 05). The percentage of pulmonary hypertension before operation in Med group was significantly greater than th...更多at in the Rat group and Pt group ( P lt;0 05), but the incidence of pulmonary complications in Rat group was significantly higher than that in the Med group and Pt group in children with VSD( P lt;0 05). The concentration of hemoglobin , the oxygen saturation and the percentage of transannular patch in Med group were significantly higher, lower and greater respectively than those in the Pt group and in Rat group in children with TOF( P lt;0 05). Conclusion The approaches to be selected should guarantee to correct the cardiac anomaly satisfactorily, reduce the postoperative complications maximally and ensure success of their operations.

      Release date:2016-08-30 06:27 Export PDF Favorites Scan
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  • 松坂南