本文選題：全胸腔鏡 + 房缺��； 參考：《中國(guó)內(nèi)鏡雜志》2017年02期

【摘要】：目的回顧性分析全胸腔鏡下行20例成人房間隔缺損修補(bǔ)手術(shù)的臨床效果,總結(jié)全胸腔鏡下心臟手術(shù)經(jīng)驗(yàn)。方法該院自2014年3月-2016年8月,采用右側(cè)股動(dòng)脈、股靜脈插管建立周?chē)w外循環(huán),主動(dòng)脈根部順行灌注冷血停跳液保護(hù)心肌,在右側(cè)胸壁打3孔完成成人房間隔缺損修補(bǔ)心臟手術(shù)20例,分析手術(shù)時(shí)間、主動(dòng)脈阻斷時(shí)間、體外循環(huán)時(shí)間、呼吸機(jī)輔助時(shí)間、胸腔引流情況、住院天數(shù)和并發(fā)癥等臨床資料。結(jié)果全組患者手術(shù)時(shí)間為3.5~5.0 h,平均(3.8±0.5)h;升主動(dòng)脈阻斷時(shí)間為28~46 min,平均(29.8±8.2)min;體外循環(huán)時(shí)間為86~108 min,平均(80.6±11.5)min;呼吸機(jī)輔助時(shí)間5~8 h,平均(6.0±0.8)h;胸腔引流量100~260 ml,平均(150.0±35.0)ml;術(shù)后住院時(shí)間6~9 d,平均(6.5±1.2)d。全組患者無(wú)手術(shù)死亡,術(shù)后無(wú)殘余分流發(fā)生,有1例患者腹股溝傷口脂肪液化,予以加強(qiáng)傷口換藥處理;1例患者胸腔積氣,予以穿刺后好轉(zhuǎn);1例患者因右側(cè)胸腔粘連改為胸腔鏡輔助,患者恢復(fù)順利,全組無(wú)嚴(yán)重并發(fā)癥發(fā)生。術(shù)后3~5天超聲心動(dòng)圖示手術(shù)效果滿意,患者順利出院。隨訪1~28個(gè)月,無(wú)殘余分流,無(wú)下肢靜脈血栓形成,心功能均為Ⅰ級(jí)。結(jié)論全胸腔鏡下成人房間隔缺損修補(bǔ)心臟手術(shù)安全可行,手術(shù)創(chuàng)傷小,切口美觀,術(shù)后引流少,患者恢復(fù)快。
[Abstract]:Objective to retrospectively analyze the clinical results of 20 adult patients with atrial septal defect (ASD) under total thoracoscopy and summarize the experience of total thoracoscopic cardiac surgery. Methods from March 2014 to August 2016, the right femoral artery was used to establish peripheral cardiopulmonary bypass (CPB), and the aortic root was perfused with cold blood cardioplegia to protect myocardium. Twenty cases of adult atrial septal defect repair were performed with 3 holes in the right chest wall. The clinical data such as operation time, aortic occlusion time, cardiopulmonary bypass time, ventilator assisted time, thoracic drainage, hospital stay and complications were analyzed. Results the operative time was 3.5 鹵5.0 h (mean 3.8 鹵0.5 min), ascending aorta occlusion time was 284min (29.8 鹵8.2 min), cardiopulmonary bypass (CPB) time was 86 ~ 108 min (mean 80.6 鹵11.5 min), ventilator assisted time was 5 ~ 8 h (mean 6.0 鹵0.8 h), thoracic drainage volume was 100 ~ 260ml (mean 150.0 鹵35.0ml), postoperative hospitalization time was 69th day (6.5 鹵1.2d). There was no operative death, no residual shunt occurred in all patients, and one patient with fat liquefaction in the inguinal wound was treated with enhanced wound dressing. After puncture, 1 case of right thoracoscopic adhesion was replaced by thoracoscopy, the patient recovered smoothly and no serious complications occurred in the whole group. Echocardiography showed satisfactory results on 3 ~ 5 days after operation, and the patient was discharged smoothly. Follow-up for 1 ~ 28 months showed no residual shunt, no venous thrombosis in lower extremities, and cardiac function was grade 鈪，

本文編號(hào)：1919424