摘要
目的:分析28例胸腔镜辅助下心脏微创手术的经验,探讨经胸腔镜体外循环心脏手术的疗效与安全性。方法:收集2011年11月至2015年6月于我院行经胸腔镜体外循环心脏手术患者28例,包括二尖瓣置换术22例,二尖瓣成形术2例,房间隔缺损2例,左房黏液瘤取出术1例及三尖瓣成形术1例;使用30°胸腔镜及配套手术器械,股动脉插供血管,股静脉插引流管行体外循环,于胸腔镜辅助下行心脏手术。结果:手术全部成功,术中无转开胸;其中体外循环时间68~120 min,平均(94.6±20.58)min;升主动脉阻断时间40~87 min,平均(63.8±15)min;出血量200~500 m L,平均(350±119.52)m L;术后24 h引流量20~350 m L,术后住院时间7~29 d,平均(13.1±7.45)d。术后出现并发症3例,包括术后左室流出道梗阻(SAM现象)1例,肺部感染1例,窦性心动过缓1例。结论:胸腔镜辅助下心脏微创手术是安全可行的,而且在二次心脏手术方面,可以避免再次开胸及粘连情况。
Objective： To evaluate the efficacy and safety of thoracoscopic cardiac surgical procedures under extracorporeal circulation. Methods： From November 2011 to June 2015, 28 patients underwent thoracoscopic cardiac surgery under extracorporeal circulation. These procedures included 1 case of left atrial myxoma, 1 case of tricuspid valvuloplasty, 2 cases of interatrial septum defect, mitral valve repair for 2 patients and mitral valve replacement for 22 patients. Thirty degree thoracoscopes and femoral extracorpereal circulation were used. The aorta was cross-clamped and the myocardium was protected by coronary perfusion with cold crystal or blood cardioplegie. Results： The operation successed in all 28 patients. Cardiopulmonary bypass time was from 68 min to 120 min with the mean of（94.6±20.58） min. Aortic cross-clamp time was from 40 min to 87 min with the mean of（63.8±15） min. The volume of bleeding was 200-500（350±119.52） m L. The volume of chest drainage in 24 hours was 20-350 m L. The postoperative hospital stay was 7-29（13.1±7.45） d. Postoperative complications occurred in 3 cases, including systolic anterior motion（SAM） in 1 patients, 1 case of pulmonary infection and arrhythmia in 1 case. Conclusion： Thoracoscopic cardiac surgical procedures for cardiac surical is feasible and safe, especially in the secondary cardiac valvular surgery.
出处
《温州医科大学学报》
CAS
2017年第1期64-66,共3页
Journal of Wenzhou Medical University
关键词
胸腔镜
心脏外科手术
心肺转流术
thoracoscopes
cardiac surgical procedures
cardiopulmonary bypass
