胸腔镜辅助小切口手术在二尖瓣置换患者中的对照研究  

A clinical controlled study of thoracoscopic assisted small incision surgery in patients with mitral valve Replacement

作　　者：黄创业[1] 何勇[1] 刘光强[1] 李中杰[1] 陈凯明 HUANG Chuangye;HE Yong;LIU Guangqiang;LI Zhongjie(Cardiovascular Surgery Gaozhou People’s Hospital,Maoming 525200,China)

机构地区：[1]广东高州市人民医院心血管外二科,525200 [2]不详

出　　处：《心肺血管病杂志》2019年第12期1253-1256,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨胸腔镜辅助小切口手术在二尖瓣置换患者中的疗效及安全性。方法:回顾性分析我院2016年1月至2018年12月,行二尖瓣置换术(MVR)患者81例临床数据资料,按照其手术方式不同分为胸腔镜辅助小切口组(40例),行右胸微MVR,常规开胸组(41例),行常规正中开胸MVR;对比分析两组术中与术后指标、疼痛程度、并发症及术后6个月超声心动参数。结果:小切口组切口长度(5.27±1.23)cm、术中输血量(1.74±0.27)U、术后引流量(205.84±10.36)mL、ICU时间(16.38±5.45)d、住院时间(8.16±2.25)d明显小于开胸组(18.12±3.54)cm,(3.22±1.35)U,(412.28±20.57)mL,(23.26±6.24)d,(12.27±3.52)d(P<0.05)。小切口组疼痛程度明显低于开胸组(χ^2=43.976,P=0.000)。小切口组(10.0%)并发症发生率明显低于开胸组(46.3%,P<0.05)。术后6个月,两组超声心动参数均明显好转(P<0.05),且组间差异无统计学意义(P>0.05)。结论:胸腔镜辅助小切口手术在MVR中对患者损伤小,患者术后恢复快,疼痛程度低且并发症少,疗效良好,值得在临床中推广应用。Objective:To investigate the efficacy and safety of thoracoscopic assisted small incision in patients with mitral valve replacement.Methods:Retrospective analysis of clinical data of 81 patients undergoing mitral valve replacement(MVR)from January 2016 to December 2018 in our hospital.According to the different surgical method,the patients were divided into thoracoscopic small incision group(40 cases).Minimally invasive MVR,conventional open thoracotomy group(41 cases),routine mid-opening thoracic MVR;comparative analysis of intraoperative and postoperative indexes,pain levels,complications and postoperative 6-month echocardiographic parameters.Results:The incision length(5.27±1.23)cm,intraoperative blood transfusion(1.74±0.27)U,postoperative drainage(205.84±10.36)m L,ICU time(16.38±5.45)d,hospitalization time(8.16±2.25)d was of the small incision group was significantly smaller than the open chest group(18.12±3.54)cm,(3.22±1.35)U,(412.28±20.57)m L,(23.26±6.24)d,(12.27±3.52)d,P<0.05.The degree of pain of the small incision group was significantly lower than that in the open chest group(χ^2=43.976,P=0.000).The incidence of complications in the small incision group(10.0%)was significantly lower than that in the open chest group(46.3%,P<0.05).At 6 months after operation,the echocardiographic parameters of both groups were significantly improved(P<0.05),and there was no significant difference between the two groups(P>0.05).Conclusions:Thoracoscopy-assisted small incision surgery has less damage to patients in MVR.The patient recovers quickly,has low pain and less complications,and has good curative effect.It is worthy of popularization in clinical practice.

关 键 词：胸腔镜辅助小切口手术 二尖瓣置换 疗效 安全性 

分 类 号：R54[医药卫生—心血管疾病]