Comparative Study Of Right Subaxillary Small Incision And Traditional Median Incision In The Treatment Of Ventricular Septal Defect

Objective: Through retrospective study contrast analysis method,comparative study perioperative right subaxillary small incision with traditional midline incision surgery clinical curative effect of pediatric ventricular septal defect correction,by studying the preoperative,intraoperative and postoperative children with clinical indicators,discusses the right subaxillary small incision in the treatment of children with congenital ventricular septal defect superiority and security,To summarize the experience of extracorporeal circulation management in the treatment of ventricular septal defect with right subaxillary mini-incision.Methods: a retrospective analysis of our hospital between January2010 and December 2015,admitted during the period of children with ventricular septal defect as the research object,in strict accordance with the criteria for the selected 80 cases,40 cases（20 male and 20 female）line right subaxillary small incision（observation group）,combination of congenital（3 cases）,atrial septal defects(tricuspid regurgitation in 2cases.Forty patients（19 males and 21 females）underwent traditional median incision（control group）,including 5 cases with congenital atrial septal defect and 1 case with tricuspid valve insufficiency.Collect medical records,Operation time（min）,cardiopulmonary bypass（CPB）time（min）,ascending aorta occlusion time（min）,average midflow perfusion flow（m L /kg）,average midflow perfusion pressure（mm Hg）,average midflow pump pressure（mm Hg）,intraoperative blood loss（ML）,postoperative ventilator use time（h）,24 after surgery were observed and compared between 2 groups H Drainage flow（ML）,ICU duration（h）,postoperative hospital stay（D）,incision length（cm）,postoperative complications,transfusion rate and hospitalization cost.Results: Patients in the right axillary small incision group（observation group）and the traditional median incision group（control group）were successfully operated,and no surgical deaths were reported.After outpatient follow-up,postoperative chest radiographs,*electrocardiogram and cardiac ultrasound showed good recovery.There were no significant differences in preoperative baseline indicators such as gender,age,weight,cardiothoracic ratio,defect size and complications between the two groups（P>0.05）.There were no significant differences in intraoperative indicators between the observation group and the control group in operation time,CPB operation time,ascending aorta blocking time,average perfusion flow during CPB rotation,and average perfusion pressure during CPB rotation（P>0.05）.The amount of intraoperative blood loss in the observation group was significantly lower than that in the control group,and the difference was statistically significant（P<0.05）.In postoperative indicators,there was no significant difference in postoperative ventilator use time and hospitalization cost between the two groups（P>0.05）,the observation group was significantly better than the median group in 24 h postoperative drainage flow,ICU monitoring time,postoperative hospital stay,incision length,postoperative blood transfusion rate and other aspects,the difference was statistically significant（P<0.05）.There was 1 case of right pneumothorax in the observation group,1 case of pulmonary infection combined with hypoxemia in the control group,and 1 case of sternal malunion.In addition,no perioperative death,ventricular residual leakage,low cardiac production,malignant arrhythmia,secondary thoracotomy,complete atrioventricular block,or serious nervous system complications occurred in the two groups.Conclusion: Line to take the right subaxillary small incision approach to safety is feasible in children with congenital ventricular septal defect correction,surgical curative effect with a median thoracotomy ventricular septal defect correction effect,and has a small incision hidden beauty,surgical trauma,quick recovery,etc advantages,combined with the corresponding extracorporeal circulation management,more conducive to the prognosis of children with,It can be the preferred surgical approach for children with simple congenital ventricular septal defect.