本文選題：房間隔缺損　切入點(diǎn)：封堵術(shù)　出處：《中國微創(chuàng)外科雜志》2017年10期 　論文類型：期刊論文

【摘要】：目的探討全胸腔鏡非體外循環(huán)下房間隔缺損微創(chuàng)封堵術(shù)治療先天性繼發(fā)孔房間隔缺損(atrial septal defect,ASD)的療效。方法 2008年5月~2016年5月186例先天性繼發(fā)孔ASD行全胸腔鏡非體外循環(huán)下房間隔缺損微創(chuàng)封堵術(shù)。全麻,右側(cè)第7肋間腋中線1.0 cm小孔置入胸腔鏡,右側(cè)鎖骨中線微切口2.0 cm,第4肋間進(jìn)胸,作為操作孔。術(shù)中經(jīng)食道超聲(TEE)引導(dǎo)下經(jīng)輸送器置入封堵器閉合ASD。結(jié)果 178例成功封堵,7例中轉(zhuǎn)胸腔鏡輔助體外循環(huán)下修補(bǔ)術(shù)(2例上腔型、3例下腔型、2例中央型由于房間隔缺損過大,封堵器影響二尖瓣結(jié)構(gòu)),1例次日心臟彩超發(fā)現(xiàn)封堵器脫落立即送手術(shù)室行開胸體外循環(huán)下直視修補(bǔ)術(shù)。無死亡,術(shù)中出現(xiàn)室上性心動(dòng)過速6例,Ⅲ度房室傳導(dǎo)阻滯3例,經(jīng)治療均轉(zhuǎn)為竇性心律;胸腔積液5例,經(jīng)引流等治療痊愈。術(shù)后3~7 d出院。178例隨訪0.5~8年,(3.2±1.9)年,彩超示封堵器無殘余漏、移位,心功能Ⅰ級70例,Ⅱ級83例,Ⅲ級25例。結(jié)論全胸腔鏡下房間隔缺損封堵術(shù)采用微切口入路,符合美容要求,無須體外循環(huán),費(fèi)用低,術(shù)后恢復(fù)快,臨床效果確切,若封堵不成功,可同期直接改體外循環(huán)下直視修補(bǔ)術(shù)。
[Abstract]:Objective to evaluate the efficacy of total thoracoscopic minimally invasive closure of atrial septal defect (ASD) in the treatment of congenital atrial septal defect (ASD). Methods from May 2008 to May 2016, 186 patients with congenital secondary atrial septal defect (ASD) underwent total thoracoscopic non-invasive closure of atrial septal defect (ASD). Minimally invasive closure of atrial septal defect under cardiopulmonary bypass. The right seventh intercostal axillary midline 1.0 cm hole was inserted into thoracoscope, the right central clavicular line microincision was 2.0 cm, and the 4th intercostal cavity was inserted into thoracic cavity. ASD was closed by transcatheter occluder under the guidance of transesophageal ultrasound (TEE) during operation. Results the successful closure of ASD was achieved in 7 cases of 7 cases of transcatheter closure under thoracoscopic assisted cardiopulmonary bypass repair of 2 cases of superior cavity type and 3 cases of inferior cavity type 2 cases of central type. Because the atrial septal defect is too large, The occluder affected the mitral valve structure in 1 case. The next day, color Doppler echocardiography found that the occluder was removed and sent to the operating room immediately for direct vision repair under cardiopulmonary bypass. There was no death, there were 6 cases of supraventricular tachycardia and 3 cases of 鈪，

本文編號：1569958