全胸腔镜下心脏手术13例临床分析  

Clinical analysis of 13 cases undergoing with total thoracoscopic cardiacsurgery

作　　者：王亮[1] 王晓明[1] 韩志伟[1] 邹龙[1] 员建平[1] 贾凡[1] 

机构地区：[1]包头市中心医院心血管外科,内蒙古自治区包头市014040

出　　处：《中国心血管病研究》2016年第2期176-178,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的总结分析13例全胸腔镜下心脏手术，探讨胸腔镜技术在心脏疾病治疗中的临床应用。方法从2012年10月至2014年12月在全麻低温体外循环下，用全胸腔镜行房间隔缺损修补术5例；室间隔修补术5例；二尖瓣置换术3例，其中同时行左房血栓清除术2例、行双极射频消融术治疗房颤1例；本组同时行三尖瓣DeVega成形术4例。结果全组无死亡及并发症发生。体外循环时间40-98（108±35）min，升主动脉阻断时间20～78（48±14）min，手术时间90-188（110±30）min。术后复查心脏彩超示，2例室间隔缺损修补术后有1-2mm针眼分流，3个月后复查示分流消失。随访1-12个月无远期死亡，无残余分流或瓣周漏。结论全胸腔镜心脏手术在简单先天性心脏病及二尖瓣置换等手术方面具有手术时间短、手术创伤小、住院时间短等优点，只要病例选择适当及加强围手术期处理，术后恢复快，切口小且隐蔽，符合美容要求，值得推广和应用。Objective Summary analysis of 13 cases under the thoracoscope cardiacsurgery, to explore the clinical application of thoracoscope technology in the treatment of cardiacsurgery. Methods From October 2012 to December 2014, under the general anesthesia and cardiopulmonary bypass and low temperature, accomplished repair of atrial septal defects in 5 patients, repair of ventricular septal defects in 5 patients, mitral valve replacement in 3 patients, including mitral valve replacement at the same time for removal of left atrial thrombosis in 2 patients, mitral valve replacement and bipolar radiofrequency ablation of atrial fibrillation in 1 patient, the group tricuspid DeVega annuloplasty in 4 patients. Results There was no death or complications in the group. Cardiopulmonary bypass time was 40-198 （108±35）min. The ascending aorta blocking time was 20-78 （48±14） min. Operation time was 90-188（ 110±30）min. Two patients of ventricular septal defect repair occur the leakage of 1-2 mm in postoperative, but the shunt disappeared after 3 months. No long-term death, residual shunt and paravalvular leakage happened during the 1-12 month follow-up. Conclusion Video-assisted thoracoscope cardiac-surgery has the advantage of shorter operation time and shorter duration of hospital stay and minimally invasive in terms of simple congenital heart disease and mitral valve replacement surgery, as long as to choose appropriate cases and strengthen the perioperative management, postoperative recovery fast, small incision and hidden, conform to the requirements of the beauty, is worth popularization and application.

关 键 词：电视胸腔镜 微创心脏手术 房、室间隔缺损修补术 心脏瓣膜置换术 

分 类 号：R654.2[医药卫生—外科学]