胸腔镜下与传统开胸左心房粘液瘤切除术的病例对照研究  

Thoracoscopic Surgery versus Median Sternotomy Surgery for Left Atrium Myxoma Excision: A Case Control Study

作　　者：刘健[1] 郭惠明[1] 谢斌[1] 陈波[1] 黄焕雷[1] 张晓慎[1] 刘菁[1] 卢聪[1] 陈寄梅[1] 庄建[1] 

机构地区：[1]广东省心血管病研究所心血管外科广东省人民医院广东省医学科学院广东省华南结构性心脏病重点实验室,广州510080

出　　处：《中国胸心血管外科临床杂志》2016年第7期671-674,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：广东省科技计划项目(2014A020212403);"十二五"国家科技支撑项目(2011BAI11B19)~~

摘　　要：目的分析胸腔镜下与传统开胸行左心房粘液瘤切除术的临床效果,为临床左心房粘液瘤切除的术式选择提供参考。方法将我院2012年1月至2014年8月69例左心房粘液瘤患者按照手术方式分为两组:胸腔镜组,30例,男8例、女22例,年龄(47.36±13.02)岁;传统开胸组,39例,男10例、女29例,年龄(49.17±13.09)岁。比较两组患者临床效果。结果两组患者术后无死亡,无严重并发症。胸腔镜组与传统开胸组相比,体外循环和主动脉阻断时间较长、但术后住ICU、术后住院和机械通气时间更短、术后胸腔引流管留置时间缩短、胸腔引流量更少且住院总费用更低,术后30 d内恢复工作比例高,两组差异均有统计学意义,P值均<0.05。两组术后早期均未发生脑梗塞等神经系统并发症。术后随访11个月至4年7个月,平均(38.5±12.7)个月,两组粘液瘤均无复发。结论与传统开胸左心房粘液瘤切除术比较,胸腔镜下左心房粘液瘤切除术有效性和安全性更佳,可作为外科治疗左心房粘液瘤优先选择术式。Objective To examine the effect and safety of thoracoscopic surgery for left atrium myxoma excision. Methods Sixty-nine left atrial myxoma patients underwent excision of left atrial myxoma in our hospital between January 2012 and August 2014 year. The patients were divided into two groups according to the procedure. Thirty patients underwent thoracoscopic surgery, as a thoracoscopic group, with 8 males and 22 females, aged 47.36±13.02 years. Thirty-nine patients received median sternotomy surgery, as a median sternotomy group, with 10 males and 29 females, aged 49.17±13.09 years. The effect and safety between the two groups were compared. Results All patients survived after surgery without death and other serious complications. Compared with the median sternotomy surgery group, longer cardiopulmonary bypass and aortic cross clamp time, shorter ICU stay, ventilator support, and postoperative drainage time, shorter hospital stay time, less postoperative drainage, lower cost, and more higher rate of returning to work in 1 month after surgery were found in the thoracoscopic group with P value less than 0.05. There was no complication of stroke and other neurological complication in the two groups. All patients were followed up for 11 months to 4 years and 7 months, average age of 38.5±12.7 months. There was no recurrence in both groups. Conclusion The thoracoscopic left atrial myxoma excision cardiopulmonary is effective and safe. It can be used as a surgical treatment of left atrial myxoma preferred.

关 键 词：胸腔镜手术 左心房粘液瘤 微创手术 

分 类 号：R732.1[医药卫生—肿瘤]