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Title:: Effects of total thoracoscopic surgery and median sternotomy on postoperative mental status of patients with heart disease

作者:: 吴帆¹; 高峰¹; 周凯²; 张近宝¹; 丁盛¹; 欧阳辉¹; 辛梅¹; (成都军区总医院心胸血管外科，四川成都 610083；
2.东莞康华医院心外科，广东东莞 523080)

Author(s):: WU Fan¹; GAO Feng¹; ZHOU Kai²; ZHANG Jin-bao¹; DING Sheng¹; OUYANG Hui¹; XIN Mei¹; (1.Department of Cardiovascular Surgery, General Hospital, Chengdu Military Area Command, Chengdu 610083, Sichuan, China；
2.Department of Cardiovascular Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guang dong, China)

关键词:: 电视胸腔镜; 正中胸骨切开术; 房间隔缺损修补术; 精神状态

Keywords:: total thoracoscopic surgery; median sternotomy; atrial septal defect repair; mental status

分类号:: R541.1

DOI:: -

文献标识码:: A

摘要:: 目的:观察全胸腔镜下心脏体外循环手术较常规正中开胸手术对术后精神状态的影响。方法:比较全胸腔镜下（胸腔镜组）和正中切口开胸（正中开胸组）进行房间隔缺损修补术患者64例在术后止痛药服用率、语言评价量表（VRS）评分、汉密尔顿抑郁量表（HAMD）评分和汉密尔顿焦虑量表（HAMA）评分等方面的差异。结果:两组患者入院时在年龄、性别、文化程度等方面比较均无统计学差异。胸腔镜组术后服用止痛药服用率显著低于正中开胸组患者（22% vs. 59%,P<0.05），胸腔镜组术后12 h和2 d VRS评分均显著低于正中开胸组，胸腔镜组术后HAMD和HAMA评分也显著低于正中开胸组（均P<0.05）。结论:全胸腔镜进行单纯房间隔缺损修补术较正中开胸手术患者术后疼痛发生率明显减少，且抑郁和焦虑负面情绪评分更低。

Abstract:: AIM:To compare the postoperative mental status in patients treated with cardiopulmonary bypass surgery by total thoracoscopy or by median sternotomy. METHODS: Differences in intake of painkillers, verbal rating scale (VRS), Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were compared in patients with atrial septal defect who underwent atrial septal defect with total thoracoscopic surgery (TTS) or median sternotomy (MS). RESULTS: Intake rate of painkillers in the TTS group was remarkably lower than that in the MS group (22 vs. 59%, P<0.05). Grading of VRS 12 h and 2 d after surgery as well as the grades of HAMD and HAMA in the TTS group were markedly lower than those in the MS group (P<0.05). CONCLUSION: Atrial septal defect repair under total thoracoscopy produces less pain and results in less depression and anxiety.

参考文献/References

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[2]王显悦,俞世强,易定华,等.电视胸腔镜与正中胸骨切开心脏手术的比较[J].心脏杂志,2007,19(6):720-722.
[3]张志新,俞世强,徐学增,等.全胸腔镜与开胸手术对心脏病患者心理卫生状况的影响[J].心脏杂志,2009,21(2):255-257.
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全胸腔镜与正中开胸手术对心脏病患者术后精神状态的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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