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|本期目录/Table of Contents|

胸部小切口瓣膜置换手术的临床研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2006年第3期
页码:
343-345
栏目:
临床研究
出版日期:
2006-06-25

文章信息/Info

Title:
Minimally invasive approach for valve replacement
作者:
马松峰; 乔峻; 霍强; 木拉提
新疆医科大学第一附属医院心外科，新疆 乌鲁木齐 830054
Author(s):
MA Song-feng;  QIAO Jun;  HUO Qiang;  Murat
Department of Cardiac Surgery, First Affiliated Hospital, Xinjiang Medical University, Urmuqi，Xinjiang 830054,China
关键词:
胸部小切口;  瓣膜置换手术; 体外循环
Keywords:
minimally invasive approach;  valve replacement;  cardiopulmonary bypass
分类号:
R654.2;R543.1
DOI:
-
文献标识码:
A
摘要:
目的 探讨各类胸部小切口瓣膜置换手术，评价其临床应用价值。方法 自1995年12月至2004年9月体外循环下手术患者103(男60，女43)例，年龄16~65岁。主动脉瓣置换（AVR）应用胸骨正中上半小切口19例；胸骨旁小切口2例；二尖瓣置换（MVR）应用胸骨正中下半切口30例；右胸前外侧小切口50例；另2例为三尖瓣置换（TVR）。结果 103例患者术后死亡3例，病死率2.9%。术后胸腔引流量、输血量比同期常规胸骨正中切口瓣膜置换手术明显减少。痊愈出院的100例，切口甲级愈合。随访3～60个月，随访率91%。心功能比术前明显提高。结论 胸部小切口瘢痕小，术后出血和输血量均明显减少，减少了住院时间和相关并发症。
Abstract:
AIM To assess the value of clinical application of minimally invasive approach for valve replacement. METHODS From December 1995 to September 2004, 103 patients (60 males and 43 females, 16 to 65 years old) underwent valve replacement operation with cardiopulmonary bypass. Aortic valve replacement was performed through upper partial sternotomy in 19 cases and through right parasternal incision in 2 cases. Mitral valve replacement was performed through lower partial sternotomy in 30 cases and through right anterolateral thoracotomy in 50 cases. Two patients received tricuspid valve replacement through right anterolateral thoracotomy. RESULTS There were 3 postoperative deaths with mortality of 2.9%. The amount of drainage and blood transfusion postoperatively was significantly reduced compared with traditional operations. Uneventful recovery was achieved in 100 cases. Ninetyone patients (91%) during 3 to 60 months followup had improved cardiac functions. CONCLUSION The minimally invasive approach for valve replacement proves to be safe with less surgical trauma and better cosmetic results.

参考文献/References

［1］ Massetti M, Babatasi G, Rossi A, et al. Operation for atrial septal defect through a right anterolateral thoractomy :current outcome［J］. Ann Thorac Surg, 1996,62（4）:1100-1103.

［2］ Lytle BW. Minimally invasive cardiac surgery［J］. Thorac Cardiovasc Surg, 1996,111(3):554-555.

［3］ Tam RKW, Almeida AA. Minimally invasive aortic valve replacement via partial sternotomy［J］. Ann Thorac Surg, 1998,65（1）:275-276.

［4］ Nair RU,Sharpe DA. Limited lower sternotomy for minimally invasive mitral valve replacement［J］. Ann Thorac Surg, 1998,65(1):273-274.

［5］ Yamada T, Ochiai R, Takeda T, et al. Comparison of early postoperative quality of life in minimally invasive versus conventional valve surgery［J］. J Anesth, 2003, 17(3):171-176.

备注/Memo

备注/Memo:
收稿日期：2005-01-13.作者简介：马松峰，副主任医师,硕士 Tel：(0991)4362601
更新日期/Last Update: