摘要
目的探讨完全胸腔镜下二尖瓣置换术治疗单纯二尖瓣病变的临床效果。方法选取单纯二尖瓣病变患者60例,根据手术方式将患者分为腔镜组(n=20)和开放组(n=40),腔镜组患者接受完全胸腔镜下二尖瓣置换术,开放组患者接受常规开胸二尖瓣置换术,比较两组患者手术情况、并发症情况以及肺功能情况。结果与开放组患者相比,腔镜组的手术时间、入住ICU时间、术后住院时间更短,术中输血量、术后胸腔引流量更少,VAS评分、并发症发生率更低(均P<0.05);两组患者的体外循环时间、主动脉阻断时间及术后呼吸机辅助时间比较,差异无统计学意义(均P>0.05)。术后1个月,两组患者的用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、最大呼气流量(PEF)均较术前明显下降(均P<0.05),但两组间比较差异无统计学意义(均P>0.05)。结论完全胸腔镜下二尖瓣置换术治疗单纯二尖瓣病变,手术创伤小、对患者机体影响较小,是一种安全可靠的方法。
Objective To explore the clinical effect of complete thoracoscopic mitral valve replacement in the treatment of simple mitral valve lesions. Methods Sixty patients with simple mitral valve lesions were selected and divided into thoracoscopic group(n=20) and open group(n=40) according to different operation modes. Patients in the thoracoscopic group underwent complete thoracoscopic mitral valve replacement, while patients in the open group were treated with conventional open mitral valve replacement. The conditions of operation, complications, and pulmonary function were compared between the two groups. Results Compared with the open group, the thoracoscopic group yielded shorter operation time, ICU stays, postoperative hospital stays, and less intraoperative blood transfusion volume, postoperative thoracic drainage volume, as well as lower VAS scores and complication incidence(all P<0.05);but there were no statistically significant differences in the time of cardiopulmonary bypass, aorta occlusion and postoperative ventilator assistance between the two groups(all P>0.05). One month after surgery, the forced vital capacity(FVC), forced expiratory volume in one second(FEV1) and peak expiratory flow(PEF) of the two groups decreased significantly compared with those before surgery(all P<0.05), but there were no statistically significant differences in the indicators mentioned above between the two groups(all P>0.05). Conclusion Complete thoracoscopic mitral valve replacement is a safe and reliable method for the treatment of simple mitral valve lesions with little trauma and little impact on the patient′s body.
作者
陈延东
CHEN Yandong(The Second People′s Hospital of Qinzhou,Qinzhou 535000,Guangxi,China)
出处
《微创医学》
2020年第3期298-300,317,共4页
Journal of Minimally Invasive Medicine
关键词
完全胸腔镜
二尖瓣置换术
二尖瓣病变
肺功能
Complete thoracoscopy
Mitral valve replacement
Mitral valve lesion
Pulmonary function
