“二孔法”胸腔镜技术在风湿性心脏病外科的临床应用研究  

The clinical application of "two-hole method" thoracoscopic technique in rheumatic heart surgery

作　　者：李树松 谭伟 冯源 李林强 LI Shu-song;TAN Wei;FENG Yuan(Nanning Third People's Hospital,Nanning 530003,China)

机构地区：[1]广西南宁市第三人民医院,530003

出　　处：《中国实用医药》2020年第29期35-37,共3页China Practical Medicine

基　　金：南宁市科学研究与技术开发计划项目(项目编号:200802116C)。

摘　　要：目的探讨"二孔法"胸腔镜技术在风湿性心脏病患者外科治疗中的应用效果与价值。方法 60例风湿性性心脏病患者,随机分为对照组和实验组,每组30例。对照组患者使用传统开胸手术治疗,实验组患者使用"二孔法"胸腔镜手术治疗。对比两组患者体外循环时间、手术时间及24 h胸腔引流量、术后3 d疼痛程度、呼吸机使用时间、重症加强护理病房(ICU)、住院时间。结果实验组患者24 h胸腔引流量(82.00±15.00)ml、呼吸机使用时间(222.50±37.00)min、ICU治疗时间(21.13±3.56)h、住院时间(7.00±1.00)d以及术后3 d疼痛程度(4.00±1.25)分均优于对照组的(391.17±107.07)ml、(504.53±77.22)min、(40.50±8.00)h、(15.00±3.00)d、(8.00±1.00)分,差异具有统计学意义(P<0.05)。结论 "二孔法"胸腔镜技术用于风湿性心脏病换瓣手术,手术创伤小,并发症少,恢复快,安全可行,值得临床推广。Objective To discuss the practical effect and value of "two-hole method" thoracoscopic technique in rheumatic heart surgery. Methods A total of 60 patients with rheumatic heart surgery were randomly divided into control group and experimental group, with 30 cases in each group. The control group was treated with traditional thoracotomy, and the experimental group was treated with "two hole" thoracoscopic surgery. The cardiopulmonary bypass time, operation time and 24 h thoracic drainage volume, pain degree 3 d after operation, ventilator use time, intensive care unit(ICU) treatment time, hospitalization time were compared between the two groups. Results The 24 h thoracic drainage volume(82.00±15.00) ml, ventilator use time(222.50± 37.00) min, ICU treatment time(21.13±3.56) h, hospitalization time(7.00±1.00) d and pain score 3 d after operation(4.00±1.25) points of the experimental group were better than(391.17±107.07) ml,(504.53± 77.22) min,(40.50±8.00) h,(15.00±3.00) d and(8.00±1.00) points of the control group, and the difference was statistically significant(P<0.05). Conclusion The "two-hole thoracoscopy" technique is safe and feasible for the operation of valve replacement in rheumatic heart disease with small trauma and less complications and quick recovery, and it is worthy of clinical promotion.

关 键 词：“二孔法”胸腔镜技术 风湿性心脏病 心脏外科 

分 类 号：R541.2[医药卫生—心血管疾病]