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目的探讨右侧开胸体外循环手术治疗先天性心脏病的应用指征及效果。方法回顾性分析678例经右侧开胸体外循环手术治疗的先天性心脏病患者的临床资料。结果室间隔缺损修补术512例,房间隔缺损修补术113例,法洛四联症根治术32例,部分型心内膜垫缺损矫治术11例,三房心矫治术5例,其他畸形手术5例;本组手术无死亡病例,术后发生并发症28例,其中术后出血行开胸止血6例,迟发心包积液经心包引流1例,Ⅲ度房室传导阻滞安装永久起搏器1例,<2mm的残余分流19例,行二次气管插管1例。结论右侧开胸手术治疗先天性心脏病由于切口隐蔽,创伤小,术后恢复快,对患儿心理影响较小,在熟练掌握常规手术技术及特殊手术技巧的基础上,是治疗先天性心脏病的较好选择。
Objective To explore the application indications and effects of right thoracotomy with extracorporeal circulation in the treatment of congenital heart disease. Methods The clinical data of 678 patients with congenital heart disease treated with right-sided open-heart surgery under cardiopulmonary bypass were retrospectively analyzed. Results There were 512 cases of ventricular septal defect repair, 113 cases of atrial septal defect repair, 32 cases of Tetralogy of Fallot, partial correction of endocardial cushion defect in 11 cases, 3 cases of cardiac correction in 5 cases and other malformations 5 cases; no deaths in this group of patients, postoperative complications in 28 cases, including postoperative hemorrhage in 6 cases of hemostasis, pericardial effusion after delayed pericardial drainage in 1 case, Ⅲ degree atrioventricular block installation permanently 1 case of pacemaker, <2mm residual shunt in 19 cases, one case of secondary tracheal intubation. Conclusion Right thoracotomy for congenital heart disease because of incision concealed, trauma, postoperative recovery fast, little psychological impact on children, in the master of conventional surgical techniques and special surgical techniques, based on the treatment of congenital heart Better choice of disease.