研究心脏外科胸骨小切口的显露范围及手术适应证。方法 :以 15具正常成人福尔马林浸泡尸体 ,建立不同平面的胸骨旁小切口模型。测量皮肤切口长度 ,经牵引后切口的内、外缘及上、下缘的最大长度。观察心脏外表及与心脏手术相关的部位的显露情况。观察经右房右侧壁切口及两房顶切口对心脏内部结构的显露情况。结果 :切除右侧第 2、第 3、第 4、第 2 ,3,第 3,4和第 2 ,3,4肋软骨的胸骨旁小切口的皮肤切口长度分别为 4.3± 0 .8,4.2± 0 .6 ,4.3± 0 .9,9.3± 0 .6 ,9.7± 0 .4和 12 .1± 0 .5cm。切除单个肋软骨可显露一定的部位 ,但范围较小。切除 2 ,3肋软骨对上腔静脉、右房、升主动脉及动脉瓣环有良好的显露 ,下腔静脉显露稍差。切除 3,4肋软骨对上腔静脉和升主动脉显露较差 ,主动脉瓣环、下腔静脉及右房显露较好 ,切除 2 ,3,4肋软骨对上腔静脉、右房、升主动脉、主动脉瓣环及下腔静脉均有较好的显露。结论 :胸骨旁小切口对病人胸前皮肤的美观影响小 ,损伤小。切除单个肋软骨可完成某些手术 ,但难度过大。切除 2、3肋软骨可完成房间隔、二尖瓣及主动脉瓣等处手术。切除 3,4肋软骨可完成房间隔、主动脉瓣、二尖瓣、三尖瓣等处的手术。切除2 ,3,4肋软骨的手术损伤稍大 ,虽操作更为方便 ,不值得提倡。胸骨 Study Cardiac Surgery Sternal small incision revealed the scope and indications for surgery. Methods: Fifteen normal adult formalin-soaked cadavers were used to establish a small parafollical incision model with different planes. Measure the incision length of the skin, the maximum length of the inner and outer edges and the upper and lower edges of the incision after traction. Observe the appearance of the heart and the location of the heart-related surgery. To observe the right side of the right wall through the right side wall incision and two roof incision on the internal structure of the heart revealed. Results: The skin incision length of the small parathral incision on the 2nd, 3rd, 4th, 2nd, 3rd, 3rd, 4th and 2nd, 3rd and 4th costal cartilage were 4.3 ± 0.8, 4.2 ± 0.6, 4.3 ± 0.9, 9.3 ± 0.6, 9.7 ± 0.4 and 12.1 ± 0.5cm. Removal of a single costal cartilage can reveal a certain area, but a smaller range. 2, 3 costal cartilage resection of the superior vena cava, right atrium, ascending aorta and the valve annulus have a good disclosure, inferior vena cava revealed a bit poor. Excision of 3,4 costal cartilage revealed inferior superior vena cava and ascending aorta, aortic annulus, inferior vena cava and right atrium revealed better, removal of 2,3,4 costal cartilage on the superior vena cava, right atrium, l Aortic, aortic annulus and inferior vena cava are better revealed. Conclusion: The small parathyroide incision has little effect on the appearance of the chest skin of the patient, with less damage. Removal of a single costal cartilage can be done some surgery, but the difficulty is too large. Removal of 2,3 costal cartilage can be done atrial septum, mitral and aortic valve surgery. Removal of 3,4 costal cartilage can be done atrial septum, aortic valve, mitral valve, tricuspid valve and other operations. Excision of 2,3,4 costal cartilage surgery slightly larger, although the operation is more convenient, not worth promoting. sternum