Objective To explore the application effect of small incision and median incision in the repair of congeni -tal atrioventricular septal defect in children with congenital heart disease .Methods A total of 80 cases of congenital heart di-sease treated in the hospital from January 2014 to January 2016 were selected as the research objects , according to the way of operation , they were divided into 40 cases of small incision group and 40 cases of median incision group , 2 groups of children were treated with intravenous inhalation anesthesia , shallow hypothermia cardiopulmonary bypass , respectively , using small incision and median incision of the lower part of the median incision and the implementation of repair .The operation time , in-cision length, 24h induced flow rate, mechanical ventilation time, aortic clamping time, cardiopulmonary bypass time, reten-tion time of intensive care unit , and postoperative hospital stay of two groups were observed , postoperative complications and follow up was compared between the two groups .Results Small incision group's operation time, incision length, postoperative 24h drainage, postoperative mechanical ventilation time were significantly lower than that in the short /median incision group ( P <0.05), while the 2 group's clamping time, CPB time, ICU stay time, postoperative hospitalization time after ascending aorta's difference were not statistically significant ( P >0.05);2 groups were compared in pulmonary effusion , atelectasis, pleural effusion, pulmonary infection, atrioventricular block, the difference were not statistically significant (χ2 =0.866,χ2 =0.000,χ2 =1.802,χ2 =2.632,χ2 =2.632, P >0.05).After 3 months of follow-up, the degree of cardiac function was grade I, small incision group without sternal deformity , median incision group had sternal malformation in 4 cases, statistically significant differences between the 2 groups were found (χ2 =10.526, P =0.001).Conclusion Small sternum underwent small incision in children with simple congenital atrioventricular septal defect repair surgery is effective , safe, under certain conditions can replace the sternal median incision way .%目的：探讨胸骨下段小切口与胸骨正中切口方式在先天性房室间隔缺损修补术中的应用效果。方法选取2014年1月—2016年1月延安大学附属医院心脏外科收治的80例先天性房室间隔缺损患儿作为研究对象，根据手术切口方式不同分为胸骨下段小切口组40例（采用胸骨下段小切口修补术）和胸骨正中切口组40例（采用胸骨正中切口方式入路）。2组患儿均采用静脉吸入复合麻醉，浅低温体外循环。观察2组患儿手术时间、切口长度、术后24 h引流量、术后机械通气时间、升主动脉阻断时间、体外循环时间、重症监护室滞留时间、术后住院时间，比较术后并发症及随访情况。结果小切口组在手术时间、切口长度、术后24 h引流量、术后机械通气时间均明显低于／短于正中切口组（ P ＜0适．05），而2组升主动脉阻断时间、体外循环时间、重症监护室滞留时间、术后住院时间比较，差异无统计学意义（ P ＞0．05）2；组患儿在肺渗出、肺不张、胸腔积液、肺部感染、房室传导阻滞等并发症比较，差异无统计学意义（χ2＝0．866、0．000、1．802、2．632、2．632，P ＞0．05）。术后随访3个月，心功能等级均为Ⅰ级，小切口组未发生胸骨畸形，正中切口组发生胸骨畸形4例，2组比较差异具有统计学意义（χ2＝10．526， P ＝0．001）。结论采用胸骨下段小切口方式行小儿先天性房室间隔缺损修补术疗效确切，安全性好，更为美观，在一定条件下可替代胸骨正中切口方式。
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