摘要
目的对比分析开胸手术和微创心脏手术治疗先天性心脏病的临床效果。方法回顾性分析2016年11月-2018年11月我院96例先天性心脏病患者的临床资料,按治疗术式分为全胸腔镜微创手术(TTS)组52例和开胸手术(MS)组44例。比较2组患者术中情况[心肺分流(CPB)时间、升主动脉阻闭时间、手术时间],术后情况(呼吸机辅助呼吸时间、24 h胸腔引流量、ICU停留时间、住院时间)及术后即刻动态肺顺应性(Cdyn)、静止呼吸顺应性(Cs)指标的差异。观察并比较2组并发症发生情况。结果2组术中情况比较差异无统计学意义(P>0.05)。TTS组呼吸机辅助呼吸时间、24 h胸腔引流量、ICU停留时间、住院时间、并发症发生率均小于MS组(P<0.05),术后即刻Cdyn、Cs大于MS组(P<0.05)。结论相较于MS,TTS应用于先天性心脏病的治疗可显著改善患者术后情况,降低对患者术后胸肺顺应性的影响,并发症少,更具优势。
Objective To compare clinical effects between thoracotomy and minimally invasive cardiac operation in treatment of patients with congenital heart disease.Methods Clinical data of 96 patients with congenital heart disease admitted during November 2016 and November 2018 was retrospectively analyzed,and the patients were divided into total thoracoscopic minimally invasive surgery(TTS)group(n=52)and thoracotomy(median sternotomy,MS)group(n=44)according to therapeutic methods.Differences in intraoperative conditions[cardiopulmonary bypass(CPB)time,ascending aorta obstruction time and operative time],postoperative conditions(ventilator-assisted breathing time,24 h chest drainage volume,ICU detention time and hospital stay)and dynamic lung compliance(Cdyn)and static breathing compliance(Cs)immediately after operation were compared between two groups,and incidence rate of complications was observed and compared between two groups.Results There were no significant differences in intraoperative conditions between two groups(P>0.05).In TTS group,values of ventilator-ASsisted breathing time,24 h chest drainage volume,ICU detention time,hospital stay and incidence rate of complications were significantly lower(P<0.05),while values of Cdyn and Cs immediately after operation were significantly higher than those in MS group(P<0.05).Conclusion Compared with those by median sternotomy,total thoracoscopic minimally invasive surgery may significantly improve postoperative conditions,reduce effect on postoperative chest lung compliance and complications in treatment of patients with congenital heart disease,and it is more advantageous.
作者
于鹏
李悟
木拉提·米吉提
王忠华
袁源
YU Peng;LI Wu;MULATI Mijiti;WANG Zhong-hua;YUAN Yuan(Department of Cardiothoracic Surgery,General Hospital of Xinjiang Military Area Command,Urumqi 830000,China)
出处
《解放军医药杂志》
CAS
2020年第2期48-50,55,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
新疆维吾尔自治区科技计划项目(201043155)
关键词
全胸腔镜微创手术
正中开胸手术
室间隔缺损
房间隔缺损
体外循环
肺顺应性
Total thoracoscopic minimally invasive surgery
Median sternotomy surgery
Heart septal defects,ventricular
Heart septal defects,atrial
Extracorporeal circulation
Lung compliance
