摘要
目的探讨全胸腔镜下房间隔缺损心内修复术的舒适性。方法选取2015年1月~2020年12月在我外科首次择期房间隔缺损心内修复术546例,按照手术方式分为腔镜组、开胸组,各273例,比较2组患者ICU期间、出院时、出院后1和3个月疼痛程度,胸廓麻木感、压气感,有无胸廓变形,有无焦虑、抑郁、恐惧不良情绪等舒适度情况和切口并发症(皮下血肿、脂肪液化、切口感染)。结果腔镜组患者在ICU期间疼痛数字分级法(Numeric Rating Scales,NRS)明显高于开胸组[(6.5±2.1)分vs.(5.3±2.2)分,t=5.736,P=0.000],其余时点腔镜组患者疼痛NRS评分均明显低于开胸组(均P=0.000)。2组患者胸廓麻木感、压气感在ICU期间无明显统计学差异(P>0.05),出院前、出院后1和3个月腔镜组均明显低于开胸组(P<0.05)。腔镜组无胸廓变形发生,开胸组出院后1、3个月胸廓变形发生率呈上升趋势,2组差异有统计学意义(P<0.05)。2组患者除在出院前焦虑、抑郁、恐惧不良情绪无差异外(P=0.785),出院后1、3个月腔镜组不良情绪均明显好于开胸组(P<0.05)。2组患者切口并发症发生率无差异(P>0.05)。结论全胸腔镜下房间隔缺损心内修复术安全有效,能够提高患者就医舒适性,值得推广应用。
Objective To investigate the comfort of total video-assisted thoracoscopic intracardiac repair of atrial septal defect.Methods A total of 546 cases undergoing intracardiac repair of atrial septal defect form January 2015 to December 2020 in our hospital were selected into the study.According to the operation method,the patients were divided into thoracoscopic group and thoracotomy group,with 273 cases in each group.The pain degree,thoracic numbness,pressure feeling,thoracic deformation,anxiety,depression and phobia,and incision complications were recorded and compared between the two groups during ICU stay,at discharge,and at 1 and 3 months after discharge.Results According to the numeric rating scales(NRS),the degree of pain in the thoracoscopic group was higher than that in the thoracotomy group during ICU stay[(6.5±2.1)points vs.(5.3±2.2)points,t=5.736,P=0.000],and lower than that in the thoracotomy group at other stages(all P=0.000).There was no significant difference in thoracic numbness and pressure feeling between the two groups during ICU stay(P>0.05),but the extant in the thoracoscopic group was significantly lower than that in thoracotomy group at discharge and 1 and 3 months after discharge(P<0.05).There was no thoracic deformation in the thoracoscopic group.The thoracic deformation rate in the thoracotomy group showed an upward trend at 1 and 3 months after discharge,and there was significant difference between the two groups(P<0.05).There was no significant difference in anxiety,depression and phobia between the two groups at discharge(P=0.785).The psychological state of the thoracoscopic group was significantly better than that of the thoracotomy group at 1 and 3 months after discharge(P<0.05).There was no significant difference in incision complication rate between the two groups(P>0.05).Conclusion Total video-assisted thoracoscopic intracardiac repair of atrial septal defect is safe and effective,which improves the patient’s medical comfort,being worthy of popularization and application.
作者
李晓密
王镇龙
兰怀
杨文举
张晓慧
徐莉莹
Li Xiaomi;Wang Zhenlong;Lan Huai(Department of Cardiovascular Surgery,General Hospital of Northern Theater Command,Shenyang 110001,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2024年第5期327-333,共7页
Chinese Journal of Minimally Invasive Surgery
基金
辽宁省民生科技基金(2021JH2/10300113)。
关键词
胸腔镜
房间隔缺损
舒适性
Thoracoscopy
Atrial septal defect
Comfort
