Li Jianrong, Liu Yinglong, Yu Cuntao, Cui Bin, Du Ming
Cardiovascular Institute, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Ann Thorac Surg. 2008 Jan;85(1):199-203. doi: 10.1016/j.athoracsur.2007.08.049.
Repair of ventricular septal defects (VSD) through a shorter right lateral thoracotomy has evolved for 10 years. However, outcomes of this surgery and patients' health-related quality of life have not been evaluated so far.
Four hundred eighty-eight patients aged 6 to 15 years who had undergone repair of VSD through a right thoracotomy were surveyed (right group) and 185 patients of the same age were surveyed who had undergone the repair through a median sternotomy (median group). Cardiopulmonary bypass, aortic cross-clamping and mechanical ventilation time, amount of drainage, postoperative hospital stay, and in-hospital mortality and morbidity were measured as short-term outcomes. Symptoms, physical signs, ultrasonic cardiogram, chest film, and electrocardiogram were followed up as long-term outcomes; and the patients' TNO-AZL Children's Quality of Life (TACQOL) were studied to evaluate their health-related quality of life. The TNO-AZL Children's Quality of Life (TACQOL) questionnaire is a 56-item child quality of life questionnaire designed by the TNO Institute of Prevention and Health and the Leiden University Hospital (TNO-AZL).
Compared with the median group, the right group's short- and long-term outcomes were more satisfactory, with less drainage (106.71 +/- 85.20 mL versus 146.70 +/- 75.63 mL) and no pigeon chest (0 versus 3). The right group's TACQOL were higher than that of the median group in physical complaints (29.58 +/- 2.8 versus 28.07 +/- 2.95), motor functioning (31.23 +/- 1.09 versus 30.53 +/- 1.60), and cognitive functioning (29.93 +/- 3.22 versus 26.87 +/- 4.24).
Repair of VSD through a right thoracotomy can provide more satisfactory outcomes and better health-related quality of life.
通过较短的右外侧开胸手术修复室间隔缺损（VSD）已发展了10年。然而，迄今为止，该手术的结果以及患者与健康相关的生活质量尚未得到评估。
对488例6至15岁通过右胸开胸手术修复VSD的患者进行了调查（右胸组），并对185例同年龄段通过正中胸骨切开术进行修复的患者进行了调查（正中组）。测量体外循环、主动脉阻断和机械通气时间、引流量、术后住院时间以及住院死亡率和发病率作为短期结果。对症状、体征、超声心动图、胸片和心电图进行随访作为长期结果；并研究患者的TNO-AZL儿童生活质量（TACQOL）以评估他们与健康相关的生活质量。TNO-AZL儿童生活质量（TACQOL）问卷是由TNO预防与健康研究所和莱顿大学医院（TNO-AZL）设计的一份包含56个条目的儿童生活质量问卷。
与正中组相比，右胸组的短期和长期结果更令人满意，引流量更少（106.71±85.20 mL对146.70±75.63 mL）且无鸡胸（0对3）。右胸组的TACQOL在身体不适（29.58±2.8对28.07±2.95）、运动功能（31.23±1.09对30.53±1.60）和认知功能（29.93±3.22对26.87±4.24）方面高于正中组。
通过右胸开胸手术修复VSD可提供更令人满意的结果和更好的与健康相关的生活质量。
