胸腔镜辅助右侧小切口在二次心脏瓣膜手术中的应用

发布时间：2019-05-29 14:28

【摘要】：目的探讨胸腔镜辅助右侧小切口在二次心脏瓣膜手术中的有效性及安全性。方法选取开展胸腔镜辅助右侧小切口二次瓣膜手术治疗的老年患者38例,男17例,女21例;其中先天性心脏病术后再次手术2例,二尖瓣闭式扩张术后二尖瓣病变16例,主动脉瓣置换术后二尖瓣病变7例,二尖瓣置换术后二尖瓣病变8例,二尖瓣成形术后5例。病例均采用右股动脉、右股静脉和(或)上腔静脉插管建立体外循环。冷血心脏停搏液顺行灌注保护心肌,经右侧胸壁小切口(3~6 cm)在胸腔镜下完成心脏手术。结果全组1例因术后引流量多再次开胸止血,无死亡病例。主动脉阻断时间(48.0±18.0)min,术后机械通气时间(6.2±3.1)h,术后胸腔引流量(150.0±28.0)ml,术后输血量(0.8±1.6)U,住ICU时间(22.0±8.0)h,术后住院时间(6.8±1.6)d。结论胸腔镜辅助下右胸小切口行二次瓣膜手术安全可靠,创伤小,恢复快,患者满意度高。
[Abstract]:Objective to investigate the efficacy and safety of thoracoscopic assisted right small incision in secondary cardiac valve surgery. Methods 38 elderly patients (17 males and 21 females) who underwent thoracoscopic assisted right small incision secondary valve surgery were selected. There were 2 cases of congenital heart disease, 16 cases of mitral valve disease after closed mitral dilatation, 7 cases of mitral valve disease after aortic valve replacement, 8 cases of mitral valve disease after mitral valve replacement, and 5 cases of mitral valvuloplasty. Cardiopulmonary bypass (cardiopulmonary bypass) was established by intubation of right thigh artery, right thigh vein and / or superior vena cava. Cold blood cardioplegia was perfused to protect myocardium, and cardiac surgery was performed under thoracoscopy through a small incision on the right chest wall (3 鈮，

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