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房间隔缺损全胸腔镜下修补和常规修补手术对比观察(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2007年第2期
页码:
215-217
栏目:
临床研究
出版日期:
2007-04-01

文章信息/Info

Title:
Comparison between totally thoracoscope and conventional surgical method in repairing arterial septal defect
作者:
李东韬; 俞世强; 徐学增; 易定华; 刘金成; 赵璧君
第四军医大学西京医院心血管外科，陕西 西安 710032
Author(s):
LI Dongtao; YU Shiqiang; XU Xuezeng; YI Dinghua; LIU Jincheng; ZHAO Bijun
Center of Cardiopulmonary Surgery, Xijing Hospital, Fourth Military Medical University, Xi′an 710033, Shaanxi, China
关键词:
房间隔缺损; 胸腔镜治疗; 细胞因子; 细胞黏附分子; 肌钙蛋白I
Keywords:
thoracoscopy; heart disease congenital; cardiac surgery; adhesion molecules; cytokines
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的 探讨先天性心脏病房间隔缺损全胸腔镜下手术与常规开胸手术方法对患者血清细胞黏附分子（ICAMI）、肿瘤坏死因子（TNFα）、白细胞介素6（IL6）和心肌肌钙蛋白I（cTnI）变化的影响。方法 全组20例，年龄9～32（17±12）岁，随机分成两组。右侧胸壁打孔（1～2 cm），体外循环，电视胸腔镜下房间隔缺损修补术（胸腔镜手术组）10例；常规开胸、体外循环、心脏停跳房间隔缺损修补术（常规手术组）10例。结果 全组无死亡。在术后12 h内，胸腔镜手术组各项指标峰值明显高于常规手术组。术后12 h以后胸腔镜手术组患者各项指标峰值下降幅度较大，而常规手术组则持续处于相对较高水平。结论 胸腔镜手术患者在术后较早时间内全身炎症反应要重于常规手术患者；随后，胸腔镜手术患者此类指标恢复较常规手术患者更早、更快。
Abstract:
AIM To compare totally thoracoscope and conventional surgical method in repairing arterial septal defect by examining the changes of soluble cytokines (TNFα, IL6), cell adhesion molecules (ICAMI) and cardiac troponin I (cTnI) during perioperative time. METHODS Twenty arterial septal defect cases, aged from 9 to 32 (17±12)years, were divided into two groups: totally thoracoscopic group (n=10) and conventional surgery group (n=10). In the totally thoracoscopic group, the arterial septal defects were repaired with total thoracoscopy and in the conventional surgery group the breast bones were cut from upper to down, cardiopulmonary bypass was set up and the arterial septal defects were repaired in the conventional way. RESULTS There was no mortality in both groups. Within 12h after operation, the serum levels of TNFα, IL6, ICAMI and cTnI in the totally thoracoscopic group were higher than those in conventional surgery group. But after 12 h, the levels of TNFα, IL6, ICAMI and cTnI in the totally thoracoscopic group decreased quickly, while TNFα, IL6, ICAMI and cTnI in conventional surgery group remained at higher level. CONCLUSION Compared with conventional surgical method, total thoracoscopy assisted technique remarkably lessens the lesion, shortens the recovery time and decreases complications.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2006-02-17.基金项目："十五"国家攻关课题（NO.2004BA720A12）通讯作者：俞世强，教授，主要从事微创心血管外科和心脏移植研究Email：yushiq@fmmu.edu.cn 作者简介：李东韬，硕士生Email：leedtyp@fmmu.edu.cn
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