摘要
目的 比较胸腔镜与开胸室间隔缺损修补术的疗效。方法 将入选的54例先天性心脏病室间隔缺损患者根据其意愿分为两组：胸腔镜组32例，采用右侧胸壁打3个小孔（直径1-2cm），股动脉、静脉、上腔静脉插管建立体外循环，阻闭升主动脉，冷晶体心脏停跳液顺行灌注保护心肌，全胸腔镜下行室间隔缺损修补手术；常规开胸组22例，采用朐骨正中切口，常规体外循环、心肌保护技术，直视行室间隔缺损修补手术。结果两组均无死亡。胸腔镜组与开胸组体外循环时间分别为（78±29）min和（73±25）min、升主动脉阻闭时间分别为（27±13）rain和（25±12）min、术后呼吸机辅助时间分别为（3.6±1．3）h和（3．5±1．2）h，两组比较差异均无显著性（P〉0．05），术后胸液引流量分别为（36±19）mL和（68±28）ml。（P〈0．01），术后住院时间分别为（5．8±1．10）d和（6．9±2．3）d（P〈0．05）。结论全胸腔镜微创手术治疗室间隔缺损创伤小，恢复快，美容效果好。安全可靠。
Objective To compare the effects of video-assisted thoracoscopic and sternotomy cardiac surgery, in ventricular septal defect. Methods Fifty-four congenital heart disease patients with ventrieular septal defect were divided into two groups： thoraeoseopy group （32 eases） and conventional sternotomy group（22 cases）. In thoraeoseopy group, video-assisted thoracoseopie cardiac surgery was performed through three holes in the right chest, and extraeorporeal circulation was set up by the femoral artery, femo- ral venous and the superior vena eava. The aorta was cross-clamped and the myoeardium was protected by coronary perfusion with cold erystalloid cardioplegie, primary closure of the defect was performed successfully, Median sternotomy cardiac surgery, conventional extraeorporeal circulation and myocardium protection, and closure of ventrieular septal defect were performed in conventional sternotomy group, Results There was no death in two groups. The durations of extraeorporeal circulation , cross-clamped and ventila- tion in thoraeoscopy group and conventional sternotomy group were （78 ±29）rain vs （73 ±25）min, （27 ± 13）min vs （25 ± 12）min, （3, 6 ± 1.3） h vs （3.5 ± 1.2）h, respectively, There was no significant differenee between two groups （P 〉0, （15）. The volume of drainage was （36 ± 19）mL vs （68 ±28）mL （P 〈0.01 ）, and hospital stay was （5.8 ± 1.1 ） d vs （6.9 ±2. 3 ） d （P 〈 0.05 ）. Conchmion Video-assisted thoraeoh seopie cardiac surgery in the treatment of ventricular septal defect is a safe and effective therapy with less invasion and rapid recovery.
出处
《微创医学》
2006年第3X期149-151,共3页
Journal of Minimally Invasive Medicine
基金
广西自然科学基金项目（合同编号：桂科自0542117）
关键词
电视胸腔镜
室间隔缺损
先天性心脏病
Thoraeoscopy
Ventrieular septal defect
Congenital heart disease
