[1]冯晓东,张勇①,王学斌①,等.腋下直切口在体外循环心脏直视手术中的应用：附612例报告冯[J].中国微创外科杂志,2009,09(7):632-634.
　Feng Xiaodong*,Zhang Yong,Wang Xuebin,et al.Application of Right Subaxillary Small Incision to Open Heart Surgery[J].Chinese Journal of Minimally Invasive Surgery,2009,09(7):632-634.
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腋下直切口在体外循环心脏直视手术中的应用：附612例报告冯()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
09
期数:
2009年7期
页码:
632-634
栏目:
出版日期:
2009-08-25

文章信息/Info

Title:
Application of Right Subaxillary Small Incision to Open Heart Surgery
作者:
冯晓东; 张勇①; 王学斌①; 万亚红; 贾宝成; 肖明第
上海远大心胸医院心血管外科，上海200235
Author(s):
Feng Xiaodong*;  Zhang Yong;  Wang Xuebin;  et al.
*Department of Cardiovascular Surgery, Shanghai YODAK Cardiothoracic Hospital, Shanghai 200235, China
关键词:
微创外科; 右腋下直切口; 心脏外科
Keywords:
Miniinvasive surgery;  Right subaxillary small incision;  Cardiac surgery
分类号:
R654.2
文献标志码:
A
摘要:
目的总结右腋下直切口在体外循环（cardiopulmonary bypass, CPB）心内直视手术中的应用体会。方法2001年3月~2008年10月，我科采用右腋下直切口（切口自腋后线腋窝下缘斜向前下至腋中线第5肋间全长4~8 cm，在第4肋骨上缘切开肋间肌，经第4肋间进胸）进行体外循环心内直视手术，其中房间隔缺损（atrial septal defect, ASD）165例，室间隔缺损（ventricular septal defect,VSD）403例，ASD合并VSD 35例，部分型心内膜垫缺损3例，部分型肺静脉畸形引流6例。结果心脏阻断时间（25.0±5.5）min，402例（65.6%）不输血，术后住院（60±4.5）d，住院期间无死亡。420例（686%）随访5~80个月，平均30个月，经心脏超声证实均恢复良好，无并发症和死亡。结论采用右腋下直切口治疗单纯ASD、VSD创伤小，恢复快，住院时间短，输血量少，术后并发症少，切口隐蔽，美观，易为病人所接受，值得推广。
Abstract:
ObjectiveTo summarize our experiences on open heart surgery through the right subaxillary small incision. MethodsBetween March 2001 and June 2008, 612 patients with congenital heart diseases were treated by open surgery trough a right subaxillary small incision via hypothermic cardiopulmonary bypass. The incision was made from the posterior axillary line at the axilla to the middle axillary line a the fifth intercostal space (4-8 cm in length), and then the intercostal muscle was cut at the inferior edge of the fourth rib for the entrance into the chest cavity. In this series, 165 patients had ASD, 403 had VSD, 35 had ASD complicated with VSD, 3 showed PECD, and 6 were found as PAPVC.ResultsThe mean cardiopulmonary bypass time was (25.0±5.5) min, 402 of the patients (65.6%) need no blood transfusion. The mean hospital stay was (6.0±4.5) d, no patient died in hospital. The 420 patients were followed up for 5 to 80 months (mean 47 months). During the period, cardiac ultrasonography showed good outcomes in the patients. No complications or death were detected.ConclusionsRight subaxillary small incision is a safe and minimally invasive method for the treatment of ASD and VSD with quick recovery, less hemorrhage, shorter hospital stay, less complications, and satisfying cosmetic outcomes.

参考文献/References:

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备注/Memo

备注/Memo:
①（山西省心血管病医院心外科，太原030024）
更新日期/Last Update: 2013-09-17