摘要
目的对比达芬奇机器人辅助与传统二尖瓣成形术的近中期疗效。方法回顾性分析2015年1月至2017年3月我院行二尖瓣成形术且完成随访74例患者的临床资料。根据手术方式将患者分为两组:达芬奇组29例,男13例、女16例,平均年龄52岁;常规组45例,男18例、女27例,平均年龄53岁。比较两组临床效果。结果两组患者的性别、年龄、体重、身高、体重指数(BMI)、心功能分级(NYHA)、高血压、糖尿病、术后输血及术后并发症差异均无统计学意义(P>0.05)。与常规组比较,达芬奇组气管插管时间、ICU滞留时间、住院时间更短,出血量及术后引流量更少(P<0.05);达芬奇组手术时间、体外循环时间、主动脉阻断时间却更长(P<0.05)。不同手术方式对术后3年患者的左心房内径(LAD)、左心室舒张期末内径(LVEDD)、左心室射血分数(LVEF)、二尖瓣反流程度(MR)无显著影响,手术方式与随访时间不存在交互作用,两组同期心脏超声评价差异无统计学意义(P>0.05)。结论达芬奇手术相较传统手术缩短了患者的康复进程,从短中期复查结果来看,与传统二尖瓣手术无差异,临床疗效满意,值得临床上进一步推广。
Objective To compare short-and medium-term effects of Leonardo da Vinci robot-assisted and traditional mitral valvuloplasty.Methods We conducted a retrospective analysis of 74 patients who underwent mitral valvuloplasty in our hospital from January 2015 to March 2017.The patients were divided into two groups according to the mode of operation:a da Vinci group(n=29,13 males,16 females at an average age of 52 years)and a routine group(n=45,18 males,27 females at an average age of 53 years).The perioperative data of patients in the two groups were compared and analyzed.Results There was no significant difference in sex,age,weight,height,body mass index(BMI),cardiac function(NYHA),hypertension,diabetes,postoperative blood transfusion and postoperative complications between the two groups(P>0.05).The tracheal intubation time,ICU retention time,hospital stay time,blood loss and postoperative drainage in the da Vinci group were shorter or less than those in the routine group(P<0.05).The operation time,cardiopulmonary bypass time and aortic clamping time in the da Vinci group were longer than those in the routine group(P<0.05).Different surgical procedures had no significant effect on left atrial diameter(LAD),left ventricular enddiastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and mitral regurgitation(MR)3 years after operation.There was no interaction between the mode of operation and the time of follow-up.There was no significant difference in echocardiographic evaluation in the same period(P>0.05).Conclusion Da Vinci operation shortens the rehabilitation process of patients compared with traditional surgery.For short-and medium-term follow-up results,there is no difference between Leonardo da Vinci and traditional mitral valve surgeries,and the clinical effect of da Vinci robotassisted mitral valvuloplasty is satisfactory,which is worthy of further clinical promotion.
作者
刘洋
张宏
胡昊宇
杨苏民
LIU Yang;ZHANG Hong;HU Haoyu;YANG Sumin(Department of Medicine,Qingdao University,Qingdao,266003,Shandong,P.R.China;Department of Cardiovascular Surgery,The Affiliated Hospital of Qingdao University,Qingdao,266003,Shandong,P.R.China)
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2020年第10期1161-1167,共7页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
国家自然科学基金青年科学基金项目(81700247)。
关键词
达芬奇机器人
二尖瓣成形术
近中期疗效
外科手术
Da Vinci robot
mitral valvuloplasty
short-and medium-term curative effect
surgery
