右前胸肋间小切口应用于Bentall手术的单中心临床效果分析  

Bentall procedure through the right anterior mini-incision:A clinical analysis in a single center

作　　者：郭锋伟[1] 姜益 郝军军[1] 钟亮 李静[1] 李勇新[1] 闫炀[1] GUO Fengwei;JIANG Yi;HAO Junjun;ZHONG Liang;LI Jing;LI Yongxin;YAN Yang(Department of Cardiovascular Surgery,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710061,P.R.China)

机构地区：[1]西安交通大学第一附属医院心血管外科,西安710061

出　　处：《中国胸心血管外科临床杂志》2023年第9期1295-1300,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的总结经右前胸肋间小切口在主动脉根部替换术(Bentall)中的效果。方法回顾性分析西安交通大学第一附属医院2020年9月—2021年9月采用右前胸肋间小切口行Bentall术患者的临床资料。结果共纳入14例患者,均为男性,年龄(55.1±9.3)岁,体重指数(24.7±2.8)kg/m^(2)。体外循环时间(185.6±32.9)min,主动脉阻断时间(144.8±30.3)min,呼吸机辅助时间(18.1±13.5)h,监护室停留时间(3.7±1.8)d,住院时间(13.4±1.6)d。5例患者出现术后并发症:3例胸腔积液、1例心包积液、1例术后出血二次开胸止血。中位随访时间4(2,6)个月,随访期间无死亡患者。学习曲线方面,术者完成4例手术后,主动脉阻断时间、体外循环时间及手术时间均较前明显缩短(P<0.05)。结论经右前胸肋间小切口路径行Bentall术安全、有效,具有临床推广价值。Objective To summarize the effectiveness of Bentall procedure through the right anterior miniincision.Methods The clinical data of patients who underwent Bentall via right anterior mini-incision from September2020 to September 2021 in the First Affiliated Hospital of Xi'an Jiaotong University were retrospectively analyzed.Results A total of 14 males with an average age of 55.1±9.3 years and body mass index of 24.7±2.8 kg/m^(2) were enrolled.The cardiopulmonary bypass(CPB)time was 185.6±32.9 min,the aortic cross-clamping(ACC)time was 144.8±30.3 min,the ventilation time was 18.1±13.5 h,the time in the intensive care unit was 3.7±1.8 d,and the hospital stay time was13.4±1.6 d.Postoperative complications occurred in 5 patients:3 patients of pleural effusion,1 patient of pericardial effusion and 1 patient of postoperative bleeding with secondary thoracotomy hemostasis.The median follow-up time was4(2,6)months.There was no mortality in the hospital or during the follow-up.As for the learning curve,the ACC time,CPB time and operation time were significantly shortened after four cases(P0.05).Conclusion The right anterior miniincision for Bentall operation is safe and effective,and has clinical value.

关 键 词：右前胸肋间小切口 BENTALL术 微创心脏外科 

分 类 号：R654.3[医药卫生—外科学]