经第2肋间主动脉瓣置换术在主动脉瓣病变患者中的临床应用  

Clinical application of transintercostal aortic valve replacement in patients with aortic valve disease

作　　者：尤阳 刘春晓 付超 杨志浩 刘子华 黄中旭 赵鑫[1] YOU Yang;LIU Chun-xiao;FU Chao;YANG Zhi-hao;LIU Zi-hua;HUANG Zhong-xu;ZHAO Xin(Department of Cardiac Surgery,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院心脏外科,山东省济南市250012

出　　处：《中国心血管病研究》2025年第4期316-320,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的 本文汇总经第2肋间行主动脉瓣置换术(AVR)的患者的临床资料,总结微创手术在心脏外科领域的临床诊疗经验,评估经第2肋间行AVR治疗主动脉瓣病变的临床应用价值。方法 纳入2023年8月~2025年1月齐鲁医院心外科二病区收治的34例患者,均采用右侧第二肋间5~7 cm横行切口,股动静脉插管建立体外循环。通过观察患者手术及术后恢复指标论证该术式的临床应用价值。结果 平均手术时间为(220.5±20.2)min,平均体外循环时间为(120.0±25.4)min,平均阻断时间为(95.0±15.8)min。术后患者恢复良好,无严重并发症,术后平均引流时间(3.0±0.5)d,平均入住重症监护室(ICU)时长(19.0±6.7)h,术后住院时间平均为(6.0±1.2)d。结论 经第2肋间AVR是一种安全、有效的微创术式,能够有效减少手术创伤,缩短恢复时间,提高患者的生活质量,适合在符合条件的患者中推广。Objective This article summarizes the clinical data of patients who underwent aortic valve replacement(AVR) through the second intercostal space,aiming to summarize the clinical diagnosis and treatment experience of minimally invasive surgery in the field of cardiac surgery,and to evaluate the clinical application value of AVR through the second intercostal space for the treatment of aortic valve disease.Methods 34 patients admitted to the Second Department of Cardiac Surgery at Qilu Hospital from August 2023 to January 2025 were accepted.All the patients underwent a 5-7 cm transverse incision through the right second intercostal space,and the femoral artery and vein cannulation was established for extracorporeal circulation.The clinical application value of this surgical technique was demonstrated by observing the surgical and postoperative recovery indicators of the patients.Results The average operation time was(220.5 ± 20.2) minutes;the average extracorporeal circulation time was(120.0 ± 25.4) minutes;and the average cross-clamping time was(95.0 ± 15.8) minutes.The patients recovered well postoperatively,with no serious complications.The average postoperative drainage time was(3.0 ± 0.5) days;the average length of stay in the intensive care unit(ICU) was(19.0 ± 6.7) hours;and the average postoperative hospital stay was(6.0±1.2) days.Conclusion AVR through the second intercostal space is a safe and effective minimally invasive procedure that can effectively reduce surgical trauma,shorten recovery time and improve the quality of life of patients,making it suitable for promotion in patients who meet the criteria.

关 键 词：微创手术 主动脉瓣置换术 手术效果 

分 类 号：R654.7[医药卫生—外科学]