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目的 总结经右胸切口行小儿体外循环心内直视手术的体会。方法 1999年 4月至 2 0 0 1年 8月 ,10 6例先天性心脏病患儿经右胸切口行心内直视根治术 ,年龄 ( 4 .3± 2 .8)岁 ( 4个月～ 14岁 ) ,体重 ( 15 .4± 6.4)kg( 6～ 3 8kg)。病种 :室间隔缺损 68例 ,2例合并二尖瓣返流 ,肺动脉高压 7例。房间隔缺损 3 7例 ,TOF1例。平均总转流时间为 ( 5 3 .9± 2 1)min ,心脏停跳时间 ( 19.2± 15 )min。平均用血量 ( 4 0 0± 5 0 )ml。术后平均呼吸机辅助时间 ( 7.11± 13 )h ,胸引流量 ( 80 .5±5 3 )ml。结果 全组治愈。术后右上或中叶肺不张 9例 ,胸腔少量积液 3例。随访时间 1个月至 2年 ,患儿情况良好。结论 本方法的优点是 :( 1)操作较简便 ,容易掌握 ,尤适用于 2～ 5岁 ,单纯房、室间隔缺损的修补 ;( 2 )手术创伤小 ,术后康复快 ;( 3 )切口美观 ,瘢痕小 ;( 4 )胸引量明显少于正中切口 ,减少术后用血
Objective To summarize the experiences of open heart surgery undergoing cardiopulmonary bypass in children with right chest incision. Methods From April 1999 to August 2001, 106 children with congenital heart disease underwent open heart surgery via the right chest incision. The patients (4. 3 ± 2. 8 years) (4 months) ~ 14 years old), weight (15.4 ± 6.4) kg (6 ~ 38kg). Diseases: 68 cases of ventricular septal defect, 2 cases with mitral regurgitation, pulmonary hypertension in 7 cases. Atrial septal defect 37 cases, TOF1 cases. The mean total transit time was (53.9 ± 21) min and heart arrest time (19.2 ± 15) min. Average blood use (400 ± 5 0) ml. Mean duration of ventilator assisted time (7.11 ± 13) h and drainage of chest (80.5 ± 53) ml. The whole group was cured. Right atrium or middle atelectasis in 9 cases, a small amount of pleural effusion in 3 cases. Follow-up time of 1 month to 2 years, children in good condition. Conclusion The method has the advantages of: (1) the operation is relatively simple and easy to grasp, especially suitable for 2-5 years old, simple room, ventricular septal defect repair; (2) surgical trauma, postoperative recovery quickly; (3) incision Beautiful, small scars; (4) significantly less than the median chest incision, reduce the use of blood