| 孙炜琪,刘锦屏,于波,等.全胸腔镜下手术治疗房间隔缺损40例临床分析[J].安徽医药,2017,21(11):2049-2051. |
| 全胸腔镜下手术治疗房间隔缺损40例临床分析 |
| Clinical analysis of atrial septal defect repaired with totally thoracoscopic process(40 cases) |
| 投稿时间：2016-11-27 |
| DOI： |
| 中文关键词: 胸腔镜 房间隔缺损 |
| 英文关键词: Thoracoscopy Atrial septal defection |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨胸壁打孔全胸腔镜下手术治疗房间隔缺损的临床效果。方法 右侧胸壁3孔,股动、静脉插管建立体外循环,特制的长阻断钳阻断升主动脉,冷晶体(含血)心脏停搏液顺行灌注保护心肌。2012年3月—2016年9月共完成全胸腔镜下房间隔缺手术40例,其中男12例,女28例,合并部分性肺静脉异位引流3例,合并中度以上三尖瓣关闭不全12例。结果 手术均成功,体外循环时间(78±23) min,升主动脉阻断时间(37±12) min,术后呼吸机辅助时间(4.2±2.1) h,术后住院时间(8.1±1.5) d。术后并发症4例:1例右侧气胸,胸腔穿刺一次治愈；1例右腋下切口液化,伤口延期愈合；1例右侧肺炎,抗感染后治愈；1例室颤,电除颤后转律,无严重并发症发生。全组术后7 d心脏彩超示房间隔无残余分流。40例术后随访3个月～4年,心功能I级。结论 全胸腔镜下手术治疗房间隔缺损安全,微创,加速康复。 |
| 英文摘要: |
| Objective To investigate the feasibility oftotally thoracoscopy operation for treating atrial septal defection. Methods From March 2012 to September 2016,40 patients with atrial septal defection included 12 males and 28 females,and 3 cases of partial anomalous pulmonary venous drainage,12 cases of moderate to severe tricuspid regurgitation.Surgical procedures were performed through 3trocars inserted at the right chest walland catheters were placed in the right femoral artery and vein to set up extracorporeal circulation.The ascending aorta was cross-clamped by using special long block forceps.The myocardium was protected by coronary perfusion with cold crystalloid(blood)cardioplegia. Results All the thoracoscopic operations were completed successfully.The mean extracorporeal circulation and cross-clamping time were(78±23) min and(37±12) min respectively.Postoperative ventilation was with drawn in(4.2±2.1) h,and the patients were discharged from the hospital in(8.1±1.5) d.4 patients had postoperative complications,including 1 case of right pneumothorax(healedby thoracentesis),and 1 case of fat liquefaction of the incision at the right axillary(delayed healing),and 1 case of right pneumonia(healedby anti-infection),and 1 case of ventricular fibrillation(healed by electrical defibrillation) without severe complication soccurred in this process.Ultrasonic Cardiogram(UCG)revealed no residual shunt of atrial septum after operation 7 d.40 cases were followed up 3 months to 4 years.During the period,the heart function was confirmed as level I. Conclusions Totally thoracoscopy surgery for treatingatrial septal defectis feasible,safe and minimal invasive,which can accelerate rehabilitation of patients. |
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