吉林医学
吉林醫學
길림의학
Jilin Medical Journal
2015年
17期
3741-3743
,共3页
右腋下切口%正中切口%先天性心脏病%儿童
右腋下切口%正中切口%先天性心髒病%兒童
우액하절구%정중절구%선천성심장병%인동
Right Subaxillary%Median Sternotomy%Congenital Heart Disease%Children
目的：对儿童先天性心脏病右腋下垂直切口手术与胸骨正中切口手术的临床治疗效果进行研究，探讨两种手术方法的优劣，从而提高儿童先天性心脏病手术治疗效果。方法：随机将儿童先天性心脏病手术治疗的患者分为两组：右腋下切口组27例，胸骨正中切口组30例，对两组手术方法在手术中主动脉阻断时间（ACC）、体外循环（CPB）时间、术中出血、手术时间、监护室（ICU）滞留时间、术后呼吸机辅助通气时间、术后引流量、术后引流管拨管时间、术后并发症、术后住院天数及术后抗生素使用等指标进行比较。结果：右腋下切口组比胸骨正中切口组手术时间长，在 ICU 滞留时间短，差异有统计学意义（P ﹤0.05），术后引流管拨管时间短、引流量少、术后抗生素使用少，差异有统计学意义（P ﹤0.01）。两组在手术中 ACC、CPB、术中出血、术后呼吸机辅助通气时间、术后并发症、术后住院天数，差异无统计学意义（P ﹥0.05）。结论：右腋下切口组，术后切口创伤小，美观，对于手术患儿成长过程的心理影响少，优于胸骨正中切口组治疗简单的儿童先天性心脏病。
目的：對兒童先天性心髒病右腋下垂直切口手術與胸骨正中切口手術的臨床治療效果進行研究，探討兩種手術方法的優劣，從而提高兒童先天性心髒病手術治療效果。方法：隨機將兒童先天性心髒病手術治療的患者分為兩組：右腋下切口組27例，胸骨正中切口組30例，對兩組手術方法在手術中主動脈阻斷時間（ACC）、體外循環（CPB）時間、術中齣血、手術時間、鑑護室（ICU）滯留時間、術後呼吸機輔助通氣時間、術後引流量、術後引流管撥管時間、術後併髮癥、術後住院天數及術後抗生素使用等指標進行比較。結果：右腋下切口組比胸骨正中切口組手術時間長，在 ICU 滯留時間短，差異有統計學意義（P ﹤0.05），術後引流管撥管時間短、引流量少、術後抗生素使用少，差異有統計學意義（P ﹤0.01）。兩組在手術中 ACC、CPB、術中齣血、術後呼吸機輔助通氣時間、術後併髮癥、術後住院天數，差異無統計學意義（P ﹥0.05）。結論：右腋下切口組，術後切口創傷小，美觀，對于手術患兒成長過程的心理影響少，優于胸骨正中切口組治療簡單的兒童先天性心髒病。
목적：대인동선천성심장병우액하수직절구수술여흉골정중절구수술적림상치료효과진행연구，탐토량충수술방법적우렬，종이제고인동선천성심장병수술치료효과。방법：수궤장인동선천성심장병수술치료적환자분위량조：우액하절구조27례，흉골정중절구조30례，대량조수술방법재수술중주동맥조단시간（ACC）、체외순배（CPB）시간、술중출혈、수술시간、감호실（ICU）체류시간、술후호흡궤보조통기시간、술후인류량、술후인류관발관시간、술후병발증、술후주원천수급술후항생소사용등지표진행비교。결과：우액하절구조비흉골정중절구조수술시간장，재 ICU 체류시간단，차이유통계학의의（P ﹤0.05），술후인류관발관시간단、인류량소、술후항생소사용소，차이유통계학의의（P ﹤0.01）。량조재수술중 ACC、CPB、술중출혈、술후호흡궤보조통기시간、술후병발증、술후주원천수，차이무통계학의의（P ﹥0.05）。결론：우액하절구조，술후절구창상소，미관，대우수술환인성장과정적심리영향소，우우흉골정중절구조치료간단적인동선천성심장병。
Objective To improve the clinical treatment effects of Congenital Heart Defects in Children by comparing the surgical meth-ods between Right Subaxillary and Median Sternotomy. Method The patients were randomly divided into two groups:Right Subaxillary group(27 cases)and Median Sternotomy one(30 cases). To compare the indexes such as aorta cross - clamping time,cardiopulmonary bypass time,intraoperative bleeding,time of operation,intensive care unit residence time,postoperative respirator assisted ventilation time, postoperative drainage volume,time for pulling out postoperative drainage tube、postoperative hospital stay and use of postoperative antibiot-ics. Results We found that the operation time in Right Subaxillary group was longer than that in Median Sternotomy. The time of intensive care unit residence in Right Subaxillary was shorter than that in Median Sternotomy group,the difference was statistically significant(P﹤ 0. 05). The time for pulling out postoperative drainage tube in Right <br> Subaxillary was shorter than that in Median Sternotomy group,the difference was statistically significant(P ﹤ 0. 01). The postoperative vol-ume of drainage and the use of postoperative antibiotics in Right Subaxillary were less than that in Median Sternotomy,the difference was statistically significant(P ﹤ 0. 01). It was unconspicuous find the differences between the aorta cross - clamping time,cardiopulmonary by-pass time,intraoperative bleeding,postoperative complications,postoperative respirator assisted ventilation time and the postoperative hospi-tal stay in two ways,the difference wasn't statistically significant(P ﹥ 0. 05). Conclusion The advantages of Right Subaxillary are small in-cision,tiny operational trauma,good appearance,less influence on the growing process of children. The clinical treatment effect of Right Subaxillary is much better than Median Sternotomy of Congenital Heart Defects in Children.
