【摘要】：目的探討胸腔鏡輔助右側(cè)小切口在二次心臟瓣膜手術(shù)中的有效性及安全性。方法選取開展胸腔鏡輔助右側(cè)小切口二次瓣膜手術(shù)治療的老年患者38例,男17例,女21例;其中先天性心臟病術(shù)后再次手術(shù)2例,二尖瓣閉式擴張術(shù)后二尖瓣病變16例,主動脈瓣置換術(shù)后二尖瓣病變7例,二尖瓣置換術(shù)后二尖瓣病變8例,二尖瓣成形術(shù)后5例。病例均采用右股動脈、右股靜脈和(或)上腔靜脈插管建立體外循環(huán)。冷血心臟停搏液順行灌注保護心肌,經(jīng)右側(cè)胸壁小切口(3~6 cm)在胸腔鏡下完成心臟手術(shù)。結(jié)果全組1例因術(shù)后引流量多再次開胸止血,無死亡病例。主動脈阻斷時間(48.0±18.0)min,術(shù)后機械通氣時間(6.2±3.1)h,術(shù)后胸腔引流量(150.0±28.0)ml,術(shù)后輸血量(0.8±1.6)U,住ICU時間(22.0±8.0)h,術(shù)后住院時間(6.8±1.6)d。結(jié)論胸腔鏡輔助下右胸小切口行二次瓣膜手術(shù)安全可靠,創(chuàng)傷小,恢復快,患者滿意度高。
[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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