摘要
目的分析二尖瓣置换术患者行电视胸腔镜辅助下置换手术的效果。方法回顾性分析我院2010年1月至2015年1月93例单纯二尖瓣病变患者的临床资料。根据手术方式将患者分为两组:电视胸腔镜辅助下二尖瓣置换术(腔镜组),43例,男25例、女18例,年龄(57.43±5.65)岁;同期常规开胸二尖瓣置换术(开胸组),50例,男27例、女23例,年龄(56.40±6.32)岁。比较两组临床结果。结果两组均无死亡病例,两组术后1周、3个月及1年心脏彩色超声心动图随访均未见明显异常。两组手术时间、主动脉阻断时间、体外循环时间、术后呼吸机辅助时间差异无统计学意义。与开胸组比较,腔镜组并发症减少,切口长度明显缩短[(5.23±1.36)cm vs.(18.21±3.89)cm],术中输血量[(1.75±0.25)U vs.(3.15±1.50)U]、术后胸腔引流量[(202.34±12.12)ml vs.(412.32±21.56)ml]及疼痛评分明显降低(1.26±0.86 vs.3.01±1.13),术后住院时间[(8.20±2.36)d vs.(12.10±3.26)d]及术后ICU监护时间[(16.53±5.16)h vs.(23.10±6.02)h]明显缩短。结论腔镜组患者术后恢复快于常规手术组、切口较常规手术组短。电视胸腔镜下二尖瓣置换术可行、安全。
Objective To compare v/deo-assisted thoracic surgical technique （VATS） and conventional surgical technique （CSM） in mitral valve replacement （MVR）. Methods We retrospectively analyzed clinical data of 93 patients in our hospital with mitral valve replacement between January 2010 and January 2015. The patients were divided into two groups including a VATS group and a CSM group.There were 43 patients with 25 males and 18 females at age of 57.43±5.65 years in the VATS group, and 50 patients with 27 males and 23 females at age of 56.40-＋6.32 years in the CSM group.The clinical outcomes of the two groups were compared. Results There was no mortality. Echocardiography was normal in both groups during 1-year follow-up. There was no significant difference between the two groups in the operative time, aortic clamping time, cardiopulmonary bypass （CPB） time, or ventilation time. As compared with the CSM group, the patients in the VATS group had a significantly lower complication rate, shorter chest incision length （5.23±1.36 cm vs. 18.21±3.89 cm）, less blood transfusion （1.75±0.25 U vs. 3.15±1.50 U）, less chest drainage （202.34±12.12 ml vs. 412.32±21.56 ml） and lower Fain score （1.26±0.86 vs. 3.01±1.13）, shorter time of postoperative hospital stay （8.20±2.36 d vs. 12.10±3.26 d）. Conclusion MVR under VATS is not only technically feasible, but also with excellent dinical results.
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2017年第9期683-686,共4页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
福建省卫生厅青年课题(2012/1/5)
福建省医学创新课题(2014-CXB-1)
卫生厅教育联合攻关项目(WJ-FJ-22)
福建省自然基金重点项目(2013Y0101)
福建省立医院优秀青年课题(2014064)
关键词
二尖瓣置换术
胸腔镜辅助
心脏手术治疗
Mitral valve replacement
video-assisted thoracoscopic surgery
cardiac surgery
