全胸腔镜下微创二尖瓣置换术  

Total thoracoscopicy cardiac surgery in minimal invasive mitral valve replacement

作　　者：王跃军[1] 程云阁[2] 王维俊[3] 潘毓标[1] 吴根社[1] 莫辉胜[1] 韦力[1] 章士刚[1] 卢峰[1] 

机构地区：[1]柳州市中医院心胸外科,广西545001 [2]上海交通大学第三附属医院心胸外科 [3]上海交通大学附属仁济医院心胸外科

出　　处：《中华胸心血管外科杂志》2009年第5期295-296,294,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的总结全胸腔镜下二尖瓣置换手术55例成功经验。方法采用右胸壁打孔，股动脉、股静脉插管建立周围体外循环，阻闭升主动脉，冷血停跳液顺行灌注保护心肌，全胸腔镜下行二尖瓣置换手术。结果手术均获成功，无死亡。手术3．6～5．6h，平均（4．6±1．0）h。体外循环90～146min，平均（118±28）min，升主动脉阻断55～85min，平均（70±15）min；术后呼吸机辅助9．2—16．4h，平均（10．2±3．1）h；胸液引流量80～350ml，平均（72±28）ml；住院10—16d，平均（13±3）d。结论全胸腔镜下二尖瓣置换手术安全可靠、创伤小、恢复快、美容效果好。Objective To summarize the experience in 55 cases of total thoracoscopicy operations in mitral valve replacement. Methods 55 selected patient＇s surgical precedures were perforated through three lateral-right chest wall holes under thoracoscopy. An arterial catheter and a venous catheter were placed in the right femoral artery, femoral vein respectively to setup extracorporeal circulation. The ascending aorta was cross-clamped with a long specially-made forceps and the myocardium was protected by coronary perfusion with cold crystalloid cardiopleige. The procedures of mitral valve replacement were performed under total thoracoscopicy. Results All the operations were successful, there was no death case. The durations of operation and extracorporeal circulation was 3.6 - 5.6（4.6 ± 1.0）h, 90 - 146 （118 ± 28）min respectively, cross-clamped time 55 - 85（70 ± 15） min, ventilation time 9.2 - 16.4（10.2±3.1）h, total chest tube drainage 80-350（72±28） ml, postoperative hospital stay 10- 16（13 ± 3）d. Conclusion Total thoracoscopicy surgery in mitral valve replacement is technically feasible and safe, having minimal invasion, rapid recovery and good cosmetology effect.

关 键 词：胸腔镜检查 心脏瓣膜假体植入 体外循环 

分 类 号：R686[医药卫生—骨科学]