经胸腔镜切除左胸交感神经治疗先天性QT间期延长综合征  

Video-assisted thoracoscopic left sympathectomy for the treatment of congenital long QT syndrome

作　　者：李剑锋[1] 王俊[1] 胡大一[2] 王乐信 李运[1] 刘彦国[1] 李梦赞[1] 张国良[1] 

机构地区：[1]北京大学人民医院胸外科,100044 [2]北京大学人民医院心血管内科,100044 [3]School of Biomedical Sciences,Charles Sturt University

出　　处：《中华外科杂志》2003年第9期660-661,共2页Chinese Journal of Surgery

摘　　要：目的　探讨经电视胸腔镜切除左胸交感神经治疗先天性QT间期延长综合征的方法和效果。　方法　 4例患者 ,采用双腔插管全身麻醉 ,在左胸壁做 2～ 3个长 1 5cm套管切口 ,经胸腔镜行左侧部分胸交感神经链切除或夹闭 ,范围包括星状神经节下 1/ 3及T2 ～T5神经链。　结果　 4例患者的校正QT间期平均值由术前的 5 37 5ms缩短至术后的 5 12 5ms ,其中 3例较术前明显缩短。平均心率较术前无明显变化。术后 1例患者出现一过性霍纳综合征 ;术后 4个月 1例症状复发 ,但频率明显降低 ,β受体阻滞剂加量后缓解。　结论　经胸腔镜切除左胸交感神经治疗先天性QT间期延长综合征 ,创伤小、疗效可靠 ;但确切的效果尚有待大宗病例进一步证实。Objective To assess the feasibility, safety and effectiveness of video-assisted thoracoscopic sympathectomy (VATS) for the treatment of congenital long QT syndrome. Methods Under general anaesthesia, pleural cavity was entered via two or three small incisions in the left intercostal space. The left thoracic sympathetic chain was identified and resected from T 2～T 5. The lower one at the third of the left stellate ganglion was also resected. Results VATS resulted in a significant shortening in corrected QT intervals in three patients. The average QT interval of the four patients was 537.5 ms before VATS and 512.5 ms after VATS. The heart rate of the patients remained unchanged. There were no major peri-operative complications apart from mild ptosis of the left upper eyelid in one patient who recovered in the following days. The syndrome recurred in one patient in syncopal events in four months after VATS. Conclusion VATS is a safe as well as an effective technique for the treatment of congenital long QT syndromes.

关 键 词：经胸腔镜切除 交感神经 治疗 先天性QT间期延长综合征 

分 类 号：R655[医药卫生—外科学]