中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

完全胸腔镜微创手术治疗室间隔缺损的疗效分析

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目的 分析完全胸腔镜与传统开胸行室间隔缺损修补术的临床效果。 方法 回顾性分析 2015 年 1 月至 2017 年 1 月我院 50 例室间隔缺损患者的临床资料。按手术方式分为两组:胸腔镜组,21 例,男 13 例、女 8 例,年龄(38.36±10.02)岁;传统开胸组,29 例,男 18 例、女 11 例,年龄(42.36±13.02)岁。比较两组患者手术时间、住院时间、呼吸机辅助时间、胸腔引流量等指标。 结果 两组患者均无死亡病例。对比传统开胸组,完全胸腔镜组体外循环时间及主动脉阻断时间延长,胸腔引流量及术后使用血制品的例数减少,住院时间缩短,两组手术时间、术后呼吸机辅助时间及重症监护室停留时间差异无统计学意义。 结论 与传统开胸比较,胸腔镜下室间隔缺损修补术安全可靠、创伤小、恢复快、节约用血,可作为外科干预的优先选择术式。

Objective To analyze the clinical efficacy of totally thoracoscopic surgery and conventional median thoracotomy surgery in the repair of ventricular septal defect (VSD). Methods We retrospectively reviewed the clinical data of 50 patients with VSD admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2015 to January 2017. According to the surgical pattern, they were divided into two groups: totally thoracoscopic group (21 patients, 13 males, 8 females, aged 38.36±10.02 years), and median thoracotomy group (29 patients, 18 males, 11 females, aged 42.36±13.02 years). The operation time, hospital stay, ventilator-assisted time and chest drainage were compared between the two groups. Results There were no deaths in both groups. In thoracoscopic group the duration of cardiopulmonary bypass (CPB) time and the aortic clamping time were longer than those of median thoracotomy group, but postoperative drainage, patients with postoperative use of blood products and postoperative hospital stay were less. There was no statistically significant difference between the two groups in operation time, postoperative ventilator-assisted time and duration of intensive care unit stay. Conclusion Compared with the traditional median thoracotomy, totally thoracoscopic VSD repair is safe and reliable, with less trauma, quicker recovery, less blood use, can be used as a preferred surgical intervention.

关键词: 胸腔镜检查; 室间隔缺损; 心脏手术

Key words: Thoracoscopic; ventricular septal defect; heart surgery

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