摘要
目的介绍一种微创心脏瓣膜替换术的新方法。方法于１９９７年３月至１９９８年４月为７３例瓣膜患者经右侧腋下胸部小切口，皮切口平均长度为（８５±０９）ｃｍ，进行了心脏瓣膜替换手术。结果平均循环阻断时间（８８６±３３８）分钟，平均转机（１１７０±４５９）分钟，有５例患者未阻断升主动脉，室颤下完成了二尖瓣替换术。术后气管插管时间（９６±３６）小时，平均胸液引流量（２６４５±１８４３）ｍｌ。１例患者院内死于脑出血。随诊中２例患者出现感染性心内膜炎，其中１例患者死亡。其他随诊良好。结论微创心脏瓣膜替换术安全可靠，可减少手术对患者的影响，利于患者恢复，同时为换瓣手术技术的改进提供了新经验。
Objective To report a new minimally invasive approach for heart valve operation. Methods Through right minimal vertical infora-axillary thoracotomy incision(by intercostel space), 68 patients with rheumatic heart disease, 2 patients with subacute endocarditis, and 3 patients with congenital heart disease underwent heart valve replacement from March 1997 to Spring 1998. Results 30 double valve replacements, 33 mitral valve replacements,10 aortic valve replacements and 14 DeVega tricuspid annuloplasties were performed. The length of the incision averaged (8 5±0 9) cm, arrest times averaged (88 6±33 8) min, cardiopulmonary bypass times averaged (117 0±45 9) min. Five mitral valve replacements were performed with ventricular fibrillation. Ventilator periods averaged (9 6±3 6) h, chest tube drainage averaged (264 5±184 3) ml. One patient died of cerebral bleeding in hospital. Two patients suffered SBE and one of them died. The results of follow up for other patients were fine. Conclusions This minimally incisive valve operation is a new safe, small wounded and cosmetic approach for heart valve replacement.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1999年第4期243-244,共2页
Chinese Journal of Surgery
