胸腔镜下与常规开胸房间隔缺损修补术临床对比分析

Clinical Comparison of Atrial Septal Defect Repair between Completed Video-assisted Thoracoscopic Surgery and Conventional Open Heart Surgery

目的探讨常规正中胸骨开胸直视下与完全胸腔镜下房间隔缺损修补术对先天性房间隔缺损患者术后恢复的影响。方法先天性房间隔缺损患者30例,分为15例开胸组行常规正中胸骨开胸直视房间隔缺损修补术和15例胸腔镜组行完全胸腔镜下房间隔缺损修补术,记录临床疗效相关数据。结果胸腔镜组的手术时间、SICU气管插管时间、术后住院时间和术后胸腔引流量均明显少于开胸组(均P<0.05),且术后4周恢复工作者的比例与开胸组比较差异具有统计学意义(P<0.05)。两组患者术后均无死亡或严重并发症的出现。术后随访3个月两组均无残余分流等异常情况。结论完全胸腔镜下房间隔缺损修补术的手术损伤较小,临床疗效较为理想,更有助于患者术后恢复。

Objective To investigate the effects on postoperative recovery after open heart surgery completed video-assisted thoraco-scopic surgery in patients with congenital atrial septal defect. Methods 30 cases diagnosed as congenital atrial septal defect were di-vided into two groups： open heart surgery group （ OHS group, 15 cases） received conventional open heart surgery and video-assisted thoracoscopic group （ VATS group, 15 cases ） underwent completed video-assisted thoracoscopic surgery. The clinical data were recorded afterwards. Results Global operating room t ime, time of tracheal intubation in SICU, length of postoperative hospital stay and volume of thoracic drainage after operation in the VATS group were significantly less than the OHS group （ all P 〈0 .05 ）, and the rate of return to work in 4 weeks of post-operation also had statistically difference between the two groups （ P 〈 0 .05 ）. All patients had no death or serious complications after the surgery. No abnormal cases like residual shunt were found in both groups during the 3 months of follow-up after operation. Conclusions Completed VATS in atrial septal defect closure offers a much less invasive alternative with desirable curative efficacy and thus is more conducive to patients＇ recovery after operation. Considering its higher social and economic benefitsWit should be vigorously promoted in the clinical treatment.