完全胸腔镜体外循环心脏手术21例分析  

Experience of totally video assisted thoracoscopy cardiac surgery in 21 cases

作　　者：钱红波[1] 张大发[1] 聂军[1] 韦俊[1] 杨敏[1] 汤天生[1] 朱雪双 

机构地区：[1]皖南医学院附属弋矶山医院胸心外科,安徽芜湖241001

出　　处：《安徽医学》2015年第5期544-547,共4页Anhui Medical Journal

摘　　要：目的总结全胸腔镜下心脏手术的经验。方法采用右侧胸壁打3个孔（1～218111），股动脉静脉插管建立体外循环的方法，对21例患者行完全电视胸腔镜下心脏手术，其中二尖瓣置换6例，房间隔缺损修补手术13例，同期行三尖瓣成形环成形术2例，DEVEGAR成形2例，室间隔缺损修补2例。观察手术时间，术后呼吸机辅助呼吸时间，术后出血量，术后疼痛，ICU监护时间，术后并发症等。结果手术时间139～246min，平均（183．67±31．49）min；体外循环时间69～176min，平均（81．43±31．56）min；升主动脉阻闭时间25～85min平均（27．31±27．72）min。术后辅助呼吸时间为3～9h，平均（3．1±4．9）h。术后患者恢复顺利。结论全胸腔镜下心脏手术创伤小，恢复快，安全可行。Objective To summarize the experience of totally video assisted thoracoscopy cardiac surgery. Methods Twenty-one patients, including 13 cases of atrial septal defect, 2 cases of ventricular septal defect and 6 cases of mitral insufficiency or stenosis, received totally video-assisted cardiac surgeries, which were performed through three lateral-right chest wall holes under thoracoscopy. Ananerial cath-eter and venous catheters were placed in the femoral artery, femoral vein respectively to set up extracorporeal circulation. The operation time, mechanical ventilation time, postoperative wound bleeding, postoperative pain, ICU monitoring time and postoperative complications were ob-served. Results There was no death among the patients. The operation time was 139~246 (183. 67 ± 31. 49 on average) min. The dura-tions of extracorporeal circulation and cross-clamped was 69~176(81. 43 ± 31. 56 on average) min and 25~85 (27. 31 ± 27. 72 on average) min respectively. Postoperative course was uneventfu1. Conclusion Totally thoracoscopic cardiac surgery is technically feasible and safe be-cause of its minimal invasion and rapid recovery.

关 键 词：完全胸腔镜辅助 体外循环 心脏外科手术 

分 类 号：R654.2[医药卫生—外科学]