全胸腔镜手术与传统开胸手术治疗简单先天性心脏病临床效果的对比研究  

A Comparative Study on Clinical Effect between Total Thoracoscopy Surgery and Traditional Thoracotomy in the Treatment of Simple Congenital Heart Disease

作　　者：张健[1] 要跟东[1] 陈德峰[1] 曹旭丹[1] 任春梅[1] 

机构地区：[1]河北省邯郸市中心医院,056001

出　　处：《实用心脑肺血管病杂志》2015年第2期61-63,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：河北省科技厅计划项目(12277738):全胸腔镜微创心脏手术在心脏外科的应用研究

摘　　要：目的比较全胸腔镜手术与传统开胸手术治疗简单先天性心脏病的临床效果。方法选取邯郸市中心医院2012—2013年收治的简单先天性心脏病患者68例,按照治疗方法分为A组38例和B组30例。A组患者采用全胸腔镜手术治疗,B组患者采用传统开胸手术治疗。比较两组患者手术前后血清肿瘤坏死因子α(TNF-α)和白介素6(IL-6)水平,手术指标及并发症发生情况。结果两组患者术前、开放主动脉时、开放主动脉后2 h、开放主动脉后12 h、开放主动脉后24 h血清TNF-α和IL-6水平比较,差异有统计学意义(P<0.05)。A组患者手术时间、呼吸机辅助时间、术后住院时间均短于B组,胸液引流量少于B组(P<0.05);两组患者体外循环时间比较,差异无统计学意义(P>0.05)。A组中5例患者出现术后并发症,B组患者未出现明显并发症。结论全胸腔镜手术治疗简单先天性心脏病较传统开胸手术更加安全、可行,患者术后恢复较快。Objective To compare the clinical effect of total thoracoscopy surgery and traditional thoracotomy in the treatment of simple congenital heart disease. Methods A total of 68 patients with simple congenital heart disease were selected in Handan Central Hospital from 2012 to 2013,and they were divided into groups A（ n = 38） and B（ n = 30） according to different treatment. Patients of A group were treated by total thoracoscopy surgery,while patients of B group were treated by traditional thoracotomy. Serum levels of TNF-α and IL-6 before and after operation, operation index and incidence of complications were compared between the two groups. Results There were significant differences of serum levels of TNF-α and IL-6 between the two groups before operation,at the moment of open aorta,2 hours after open aorta,12 hours after open aorta and 24 hours after open aorta（ P〈0. 05）. Operation time,mechanical ventilation time,hospitalization time after operation of A group were shorter than those of B group,and chest fluid drainage volume of A group was less than that of B group（ P〈0. 05）. No significant differences of extracorporeal circulation time was found between two groups（ P〈0. 05）. In A group,5cases occurred complications,no one of B group occurred any complications. Conclusion Total thoracoscopy surgery is more safe and more feasible than traditional thoracotomy in the treatment of simple congenital heart disease,is helpful to promote the recovery.

关 键 词：心脏病 胸腔镜检查 心脏外科手术 疗效比较研究 

分 类 号：R541[医药卫生—心血管疾病]