摘要
比较电视胸腔镜辅助下(VATS)微创主动脉瓣置换(Mini-AVR)与传统胸骨正中切口主动脉瓣置换(Full-AVR)的疗效和安全性。63例Mini-AVR为微创组,其中52例胸骨上段小切口,11例右胸前外侧小切口;135例Full-AVR为对照组。比较两组一般资料及术中、术后相关指标和预后,并对比两种小切口的疗效。Mini-AVR组心功能(NYHA)IV级占比小于Full-AVR组,差异有统计学意义(P<0.01)。Mini-AVR组体外循环和升主动脉阻断时间大于Full-AVR组(P<0.01),ICU留住时间、术后住院时间、切口长度、术后第1天引流量、胸管留置时间、输注红细胞用量均较Full-AVR组减少(P<0.01)。右胸前外侧小切口体外循环及升主动脉阻断用时最长,差异有统计学意义(P<0.01)。VATS下Mini-AVR安全有效,其中首选胸骨上段小切口,次选右胸前外侧小切口。
To compare the clinical outcomes and safety of minimally invasive incision via video-assisted thoraco-scopic surgery(VATS)and traditional median full sternotomy incision for aortic valve replacement(AVR).There were 63 patients underwent AVR via minimally invasive incision as Mini-AVR group including 52 cases through partial upper mini-sternotomy and 11 cases through right anterior minithoracotomy.135 patients were undergone tra-ditional median full sternotomy AVR as control group(Full-AVR group).The preoperative general data,intraoper-ative and postoperative indicators and prognosis were compared between the two groups.The clinical effects were also compared between the two minimally invasive incisions.The proportion of New York heart association(NYHA)grade IV in the Mini-AVR group was less than that in the Full-AVR group and the difference was statistically signif-icant(P<0.01).The cardiopulmonary by pass and aortic cross-clamp time in Mini-AVR group were significantly longer than that in Full-AVR group(P<0.01).However,the duration of ICU stay time and post-operative hospi-tal stay,incision length,volume of drainage on the first day postoperative,chest tube duration,and volume of red blood cell transfusion in Mini-AVR group were significantly lower than those in Full-AVR group(P<0.01).The cardiopulmonary bypass(CPB)time and aortic cross-clamp time of right anterior minithoracotomy were the longest in three methods for AVR,with statistically significant difference(P<0.01).The Mini-AVR via VATS is safe and effective,among which partial upper mini-sternotomy is preferred and right anterior minithoracotomy is the second choice.
作者
赵智伟
张海洋
阮鹏
张锐
樊扬名
葛建军
Zhao Zhiwei;Zhang Haiyang;Ruan Peng(Dept of Cardiovascular Surgery,The First Affiliated Hospital(Anhui Provincial Hospital)of University of Science and Technology of China,Hefei 230001)
出处
《安徽医科大学学报》
CAS
北大核心
2020年第9期1460-1465,共6页
Acta Universitatis Medicinalis Anhui
基金
安徽省科技重大专项(编号:18030801132)。
关键词
电视胸腔镜手术
微创
主动脉瓣置换
完全劈开胸骨
video-assisted thoracoscopic surgery
minimally invasive
aortic valve replacement
full sternotomy
