经胸骨上段J形小切口主动脉瓣置换术安全性及有效性分析  

Safety and efficacy analysis of aortic valve replacement through small incision in upper sternal segment

作　　者：张航[1] 王华君 吴雪达 张洁琼 李璐瑜 安景辉[1] Zhang Hang;Wang Huajun;Wu Xueda;Zhang Jieqiong;Li Luyu;An Jinghui(Department of Cardiac Surgery,theSecond Hospital of Hebei Medical University,Shijiazhuang 050000,China.)

机构地区：[1]河北医科大学第二医院心脏外科,石家庄050000

出　　处：《中国循证心血管医学杂志》2025年第2期205-207,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河北医科大学第二医院科学研究基金项目(2HC202213)。

摘　　要：目的探讨经胸骨上段J形小切口主动脉瓣置换术的安全性及有效性。方法选取2017年3月至2023年8月于河北医科大学第二医院心脏外科行主动脉瓣置换术患者60例,其中经胸骨上段J形小切口主动脉瓣置换术患者30例(微创组),传统全胸骨切开主动脉瓣置换术患者30例(传统组)。比较两组升主动脉阻断时间、手术时间、术后机械通气时间、ICU停留时间、术后24 h引流量、主要心血管事件(Major Adverse Cardiovascular Events,MACE)发生率。结果微创组与传统组相比,术中升主动脉阻断时间、手术时间差异无统计学意义(P>0.05);术后机械通气时间、术后ICU停留时间、术后24 h引流量微创组明显低于传统组(P<0.05);微创组术中中转传统开胸手术1例(考虑与患者体型肥胖、暴露困难相关),两组患者围手术期内均无死亡病例,术后无二次开胸病例,术后均未出现伤口愈合不良等相关并发症。结论经胸骨上段J形小切口行主动脉瓣置换术安全、有效,且具有一定优势。Objective To investigate the safety and efficacy of aortic valve replacement through J-shaped small incision in the upper sternal segment.Methods A total of 60 patients undergoing surgical aortic valve replacement in the Department of Cardiac Surgery,Second Hospital of Hebei Medical University from March 2017 to August 2023 were selected,including 30 patients undergoing upper sternal J-shaped small incision aortic valve replacement(minimally invasive group)and 30 patients undergoing traditional total sternotomy aortic valve replacement(traditional group).The time of ascending aorta occlusion,operation time,postoperative mechanical ventilation time,ICU stay time,postoperative drainage volume 24 hours,and the incidence of Major Adverse Cardiovascular Events(MACE)were compared between the two groups.Results There was no significant difference between the minimally invasive and traditional groups in the duration of ascending aorta occlusion and operation(P>0.05).The postoperative mechanical ventilation time,postoperative ICU stay time,and postoperative 24-hour drainage volume in the minimally invasive group were significantly lower than in the traditional group(P<0.05).One patient in the minimally invasive group underwent traditional thoracotomy during the operation(considering that it was related to the patient's obesity and exposure difficulties),and there were no deaths in the perioperative period,no cases of secondary thoracotomy after surgery,and no postoperative complications such as poor wound healing.Conclusion Aortic valve replacement through a small incision in the upper sternal segment is safe,effective,and has certain advantages.

关 键 词：主动脉瓣置换术 胸骨上段 

分 类 号：R542.5[医药卫生—心血管疾病]