完全胸腔镜下手术治疗先天性室间隔缺损50例体会  

Experience of totally thoracoscopic surgery in 50 cases of congenital ventricular septal defect

作　　者：陈现杰[1] 王国锋[2] 刘洋[2] 张建卿[2] 

机构地区：[1]新乡医学院研究生处,河南省新乡市 453003 [2] 郑州市第七人民医院心外科

出　　处：《中国心血管病研究》2014年第11期1026-1028,1054,共4页Chinese Journal of Cardiovascular Research

基　　金：河南省卫生科技创新人才工程项目，郑州市普通科技攻关项目

摘　　要：目的 总结50例完全胸腔镜下室间隔缺损修补手术的临床疗效.方法 选取50例先天性室间隔缺损患者,应用股、动静脉建立体外循环,右侧胸壁打“3孔”,在完全胸腔镜下行室间隔缺损修补术,观察手术效果.结果 50例先天性室间隔缺损患者均在完全胸腔镜下顺利完成室间隔缺损的修复,手术时间3.0～5.8（3.5± 1.3）h,体外循环时间60～152（110±25）min,升主动脉阻断时间25～98（55±15）min,术后呼吸机辅助时间3.0～6.5（3.0±1.6）h,监护室停留时间14～36（15.0±8.5）h,术后胸液引流量58～230（65± 19）ml,术后自行下床时间15～30（20.0±7.5）h,术后住院4～10（5.0± 1.5）d.术后1周和3个月复查心电图均为窦性心律,无传导阻滞出现;心脏彩超示室间隔未见残余分流,心功能正常;胸部X线片示右侧肺部、胸廓未见明显异常.结论 完全胸腔镜下室间隔缺损修补手术是安全有效的,具有创伤小、疼痛轻、术后恢复快等优点.Objective To summarize the experience ventricular septal defect repair in full thoracoscopic surgery. Methods 50 cases of patients with congenital ventricular septal defect were selected and undergone with femoral arteriovenous build around CPB. Right chest wall was perforated with ＂three holes＂, and ventrieular septal defect was repaired by completely thoracoscope. The effects of surgery were observed. Results 50 cases of patients with congenital ventricular septal defects were successfully completed entirely thoracoscopic repair of ventricular septal defect, operative time was 3.0-5.8（3.5±1.3）h, cardiopulmonary bypass time of 60-152（110±25）min. As- cending aorta resistance just time was 25-98 （55± 15 ）min, postoperative ventilation time was 3.0-6.5 （ 3.0± 1.6）h, ICU stay time was 14-36 （15.0±8.5）h, postoperative pleural fluid drainage was 58-230 （65±19）ml, after getting out of bed on their own time 15-30 （20.0±7.5）h, postoperative hospital days 4-10 （5.0± 1.5 ）days; electrocardiogram were in sinus rhythm after one week, and has no conduction block occured, echocardiography displayed no residual shunt in septal, and the heart function was normal. Chest X radiograph showed no abnormalities of the right lung and thorax; after three months later, electrocardiogram and echocardiography showed same above. Conclusion Totally thoracoscopic repair of ventricular septal defect surgery is safe and effective, with less trauma, pain, quick recovery after surgery.

关 键 词：胸腔镜 手术治疗 先天性心脏病 室间隔缺损 

分 类 号：R654.2[医药卫生—外科学]