[1]宋宝国,魏 涛,王 沙,等.房间沟及房间隔入路胸腔镜下二尖瓣手术临床应用研究[J].陕西医学杂志,2022,51(7):866-869.[doi:DOI:10.3969/j.issn.1000-7377.2022.07.024]
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房间沟及房间隔入路胸腔镜下二尖瓣手术临床应用研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年7期
页码:
866-869
栏目:
临床研究
出版日期:
2022-07-05

文章信息/Info

作者:
宋宝国; 魏 涛; 王 沙; 刘 强
(陕西省人民医院心血管外科,陕西 西安710068)
关键词:
房间沟入路;  房间隔入路;  二尖瓣手术;  胸腔镜;  安全性;  有效性
分类号:
R 654.2
DOI:
DOI:10.3969/j.issn.1000-7377.2022.07.024
文献标志码:
A
摘要:
目的:探究经房间沟及房间隔两种不同入路方式胸腔镜下行二尖瓣手术的安全性和有效性。方法: 选择行胸腔镜下二尖瓣手术的患者46例,其中21例经房间沟入路(房间沟组),25例经右心房-房间隔入路(房间隔组)。比较两组手术、围术期及随访资料。结果: 全组无手术死亡。房间隔组体外循环时间长于房间沟组[(128.6±25.4)min比(96.6±26.5)min],差异有统计学意义(P<0.05); 房间隔组主动脉阻断时间长于房间沟组[(89.4±16.2)min比(72.5±16.8)min],但差异无统计学意义(P>0.05)。房间沟组术后24 h引流量多于房间隔组[(301.0±85.7)ml比(108.0±54.4)ml],差异有统计学意义(P<0.05)。两组重症监护时间[(3.5±2.1)d比(4.2±1.3)d]及住院时间[(11.8±3.5)d比(13.4±4.1)d]比较差异无统计学意义(均P>0.05)。房间沟组1例中转开胸,房间隔组无中转。两组均无死亡。术后随访3～60个月,平均(36±8)个月。两组术后3年生存率分别为100%和96%(均P>0.05),均无再次手术。二尖瓣成形手术后,中度以上二尖瓣反流复发豁免率,房间隔组大于房间沟组,分别为98%和74%,两组比较差异有统计学意义(P<0.05)。结论: 胸腔镜二尖瓣手术采用房间隔入路较房间沟入路手术难度相对较大,达到手术熟练度学习曲线更长,但术后引流量更少,且瓣膜成形效果更好。

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更新日期/Last Update: 2022-07-05