右前外侧小切口微创心脏手术的临床研究

目的探讨右前外侧小切口微创心脏手术的临床疗效。方法选取二尖瓣病变或房间隔缺损患者43例,将其分成小切口组21例和正中切口组22例。比较两组患者疼痛度、输血量、术后引流量、建立体外循环时间、阻断时间、ICU监护时间及转流时间。结果小切口组建立体外循环时间、转流时间及阻断时间均与正中切口组无显著差异,而切口长度、引流量、输血量、术后呼吸机通气时间、ICU监护时间、住院时间、曲马多使用次数均较正中切口组减少,差异具有显著性。小切口组出现右肺局限性肺不张2例。因主动脉根部插管部位出血延长切口止血1例,起搏导线失效1例,二次开胸止血1例。结论右胸前外侧小切口行微创心脏手术安全有效,美容效果好,但需注意防止并发症的发生。

Study on micro-invasive heart operation through right anterior mini-thoracotom y

Objective To evaluate the effect of micro-invasive heart operation through right anterior mini- thoracotomy. Methods A total of 43 patients with same standard were divided into minimally invasive surgery group（ n = 21 cases） and sternotomy group（ n = 22 cases）.The volume of blood transfusion,postoperative suction drainage,cardiopulmanary bypass time,blocking time,ICU time and cross clamp time were compared between these two groups. Results The difference in cardiopulmanary bypass time,blocking time,and cross clamp time between these two groups was not significant. The incision length,flow rate and amount of blood transfusion,postoperative respiratory machine ventilation time and ICU time,hospitalization stay and times for tramadol application in minimally invasive surgery group were significantly lower than those of sternotomy group and their difference was statistically significant. There were 1 case with re- operation due to bleeding and 1 case for extended intraoperative incision in minimally invasive surgery group. Conclusion Micro- invasive heart operation through right anterior mini- thoracotomy is safe and effective,with good cosmetic result,but it needs to prevent the occurrence of complications,and it is worthy to be clinically applied.