完全胸腔镜微创手术治疗心脏粘液瘤的效果及并发症研究  

Effect and Complications of Totally Thoracoscopic Minimally Invasive Surgery in the Treatment of Cardiac Myxoma

作　　者：董晓龙[1] 屈颖聪[1] 周冬冬[1] DONG Xiaolong;QU Yingcong;ZHOU Dongdong(Jiaozuo People's Hospital,Jiaozuo,454150)

机构地区：[1]河南省焦作市人民医院,454150

出　　处：《实用癌症杂志》2023年第3期450-453,457,共5页The Practical Journal of Cancer

摘　　要：目的 探讨完全胸腔镜微创手术治疗心脏粘液瘤的效果及并发症。方法 回顾性分析心脏粘液瘤患者81例,根据手术方式的不同将入组患者分为观察组(n=46)和对照组(n=35)。对照组患者采用传统开胸手术治疗,观察组患者采用完全胸腔镜微创手术治疗。记录2组患者手术相关指标(术中出血量、气管插管时间、手术时间、手术切口及体外循环时间)和术后恢复指标[住院时间、住重症监护室(ICU)时间及疼痛程度]。于手术前后,比较2组患者心肌谱酶指标[肌钙蛋白I(cTnI)、肌酸激酶(CK)及乳酸脱氢酶(LDH)]及心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)及左心室收缩末期内径(LVESD)];并记录患者并发症的发生情况。结果 观察组患者术中出血量、气管插管时间、手术切口均显著少(短)于对照组,体外循环时间显著长于对照组,差异具有统计学意义(P<0.05);2组患者手术时间比较无显著差异(P>0.05);观察组患者住院时间、住ICU时间及VAS评分均显著短(低)于对照组,差异具有统计学意义(P<0.05)。术后2组患者LVEDD、LVESD水平均降低,LVEF水平升高,但2组比较无统计学差异(P>0.05);术后2组患者CK及LDH水平升高,cTnI水平降低,但2组比较差异无统计学意义(P>0.05)。观察组患者并发症发生率显著低于对照组(8.70%vs 25.71%)(P<0.05)。结论 完全胸腔镜微创手术治疗心脏粘液瘤具有较高的安全性,术中出血量较少,并发症较少,有助于术后早期恢复。Objective To explore the effect and complications of totally thoracoscopic minimally invasive surgery in the treatment of cardiac myxoma.Methods A total of 81 patients with cardiac myxoma were retrospectively analyzed.According to different surgical methods, they were divided into the observation group(n=46) and the control group(n=35).The patients in the control group were treated with traditional thoracotomy, while those in the observation group were treated with totally thoracoscopic minimally invasive surgery.The surgical related indexes(intraoperative blood loss, endotracheal intubation time, operation time, surgical incision, cardiopulmonary bypass time) and postoperative recovery indexes [hospitalization time, stay time in intensive care unit(ICU),pain degree] in both groups were recorded.The myocardial enzymes [cardiac troponin I(cTnI),creatine kinase(CK),lactate dehydrogenase(LDH)] and cardiac function indexes [left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)] were compared between the 2 groups.The occurrence of complications was recorded.Results The intraoperative blood loss, tracheal intubation time and surgical incision in observation group were significantly lower than those in control group, and cardiopulmonary bypass time was significantly longer than that in the control group(P<0.05).There was no significant difference in operation time between the 2 groups(P>0.05).The hospitalization time, stay time in ICU and VAS score in the observation group were significantly lower than those in the control group(P<0.05).After surgery, LVEDD and LVESD were decreased, while LVEF was increased in both groups, but there was no significant difference in the three indexes between the 2 groups(P>0.05).After surgery, levels of CK and LDH were increased, while cTnI was decreased in both groups, but there was no significant difference in the three indexes between the 2 groups(P>0.05).The incidence of complications in the observation g

关 键 词：完全胸腔镜微创手术 心脏粘液瘤 并发症 疼痛 术后恢复 

分 类 号：R732.1[医药卫生—肿瘤]