胸腔镜辅助体外循环下心脏不停跳房间隔缺损修补术的临床疗效  

Clinical efficacy of thoracoscopic beating heart surgery with cardiopulmonary bypass for atrial septal defects repair

作　　者：梁春水[1] 陈林[1] 肖颖彬[1] 蹇朝[1] 文仁国[1] 刘泓[1] 刘建[1] 马瑞彦[1] Liang Chunshui;Chen Lin;Xiao Yingbin;Jian Zhao;Wen Renguo;Liu Hong;Liu Jian;Ma Ruiyan(Department of Cardiovascular Surgery,Xinqiao Hospital,Third Military Medical University,Chongqing 400037,China)

机构地区：[1]第三军医大学新桥医院全军心血管外科研究所,重庆400037

出　　处：《中国体外循环杂志》2020年第6期360-362,共3页Chinese Journal of Extracorporeal Circulation

基　　金：国家重点研发计划(NO2016YFC1301900);军队后勤科研重大项目(ALJ17J001)。

摘　　要：目的总结胸腔镜辅助体外循环下心脏不停跳修补房间隔缺损106例患者的临床资料,探讨胸腔镜和心脏不停跳技术结合治疗房间隔缺损临床疗效。方法采用右侧胸壁三孔法入路,自股动、静脉插管建立体外循环,术中保持浅低温(32~34℃)心脏不停跳,创新建立左心房-左心室同期引流术,改善术野,在胸腔镜辅助下修补房间隔缺损和治疗合并畸形。结果全组106例无死亡,体外循环时间36~97 min,术中延长切口3例,并发液气胸2例,平均住院时间5~7 d,出院后随访12~60个月,全部恢复良好,无并发症发生。结论胸腔镜结合心脏不停跳技术治疗房间隔缺损创伤小、恢复快,是一种安全有效的方法。Objective To explore the clinical efficacy of combining thoracoscopy and beating-heart technique in the treatment of atrial septal defects(ASD).A total of 106 cases of thoracoscopic beating heart surgery with cardiopulmonary bypass(CPB)for ASD repair were collected and analyzed.Methods The femoral artery and vein were cannulated to establish CPB and the right chest wall approach with 3-ports was applyed.Mild hypothermia(32-34℃)was maintained intraoperatively.Simultaneous drainage of both left atria and ventricle was established during the thoracoscopic beating heart surgery.ASD and concomitant deformities were repaired at the same time.Results No deaths were reported.There were 3 cases of intraoperative incision extension and 2 cases of postoperative pneumothorax.The CPB time was 36-52 min and the mean hospital stay was 5-7 days.Patients were followed up for 12-60 months,and no complications were observed.Conclusion The combination of thoracoscopy and beating heart technique for the treatment of ASD is a feasible and safe surgical procedure with minimal trauma and fast recovery.

关 键 词：胸腔镜 不停跳心脏手术 房间隔缺损修补 体外循环 微创心脏手术 

分 类 号：R654.2[医药卫生—外科学]