摘要
目的探讨微创切口联合腹腔镜同期治疗先天性心脏病合并心外畸形安全性及可行性。方法选取2015年11月至2023年4月于首都儿科研究所附属儿童医院心脏外科收治的24例采用微创切口联合腹腔镜同期治疗先天性心脏病合并心外畸形患儿(微创联合组),以及年龄、体重、心脏畸形、手术方式、心功能及麻醉ASA分级相匹配的24例单纯先天性心脏病患儿(单纯先心病组)作为研究对象。统计分析两组患儿术中、术后等临床指标差异性。结果微创联合组患儿均成功施行联合手术,术后无明显并发症,两组患儿均成功治愈出院;与单纯先心病组相比,微创联合组患儿麻醉时间及手术时间明显延长,手术费用明显增多,差异有统计学意义(P<0.05),但体外循环时间、主动脉阻断时间、术中出血量,术后气管插管时间、CICU时间、住院时间、麻醉费用、住院费用等指标差异无统计学意义(P>0.05);微创联合组与单纯先心病组术后早期血流动力学指标比较,术后8 h CCE明显高于单纯先心病组(P<0.05),其余术后各时点CCE差异无统计学意义;两组CI、dp/dt、Glu、Lac、IS指标在术后0、4、8、12、16、20、24 h差异均无统计学意义(P>0.05)。结论微创切口联合腹腔镜同期治疗先天性心脏病合并非心脏畸形安全可行,同时具有切口美观的优点,值得临床推广。
Objective To investigate the safety and feasibility of combined minimally invasive incision and laparoscopy for the treatment of congenital heart disease(CHD)with extracardiac anomalies.Methods Twenty-four cases of CHD with extracardiac anomalies treated with combined minimally invasive incision and laparoscopy(minimally invasive group)and 24 cases of simple CHD matched for age,weight,cardiac malformation,surgical approach,cardiac function,and ASA classification(simple CHD group)were selected from Nov.2015 to Apr.2023 at the Affiliated Children′s Hospital of Capital Institute of Pediatrics.Clinical indicators during and after surgery were statistically analyzed for differences between the two groups of patients.Results Minimally invasive combined surgeries were successfully performed on the group of patients,and there were no significant postoperative complications.Both groups of patients were successfully cured and discharged from the hospital.The anesthesia time and operation time in the minimally invasive group were significantly prolonged compared to the simple CHD group,with statistical significance(P<0.05).However,there were no significant differences in extracorporeal circulation time,aortic cross-clamp time,intraoperative blood loss,postoperative endotracheal intubation time,CICU time,length of hospital stay,anesthesia costs,surgical costs,and hospitalization costs(P>0.05).In the comparison of early postoperative hemodynamic indicators between the minimally invasive group and the simple CHD group,CCE at 8 hours postoperatively was significantly higher in the minimally invasive group(P<0.05),while there were no statistically significant differences in CCE at other time points.There were no significant differences in CI,dp/dt,Glu,Lac,and IS indicators between the two groups at 0,4,8,12,16,20,and 24 hours postoperatively(P>0.05).Conclusion Combined minimally invasive incision and laparoscopy for the treatment of CHD with extracardiac anomalies is safe and feasible,and it has the advantage of aesthetic inci
作者
王双兴
吴永杰
孟兵
张宏涛
刁美
张辉
Shuangxing Wang;Yongjie Wu;Bing Meng;Hongtao Zhang;Mei Diao;Hui Zhang(Department of Cardiac Surgery,Children′s Hospital Capital Institute of Pediatrics,Beijing 100020,China;Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of General Surgery,Children′s Hospital Affiliated to the Capital Institute of Paediatrics,Beijing 100020,China)
出处
《中华腔镜外科杂志（电子版）》
2024年第4期244-249,共6页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
基金
首都儿科研究所所级课题资助(LCYJ-2025-21,LCYJ-2023-25)。
关键词
先天性心脏病
心外畸形
同期手术
微创切口
Congenital heart disease
Extracardiac anomalies
Simultaneous surgery
Minimally invasive incision
