电视胸腔镜在小儿先天性心脏病中的应用

Thoracoscopy cardiac surgical operation on congenital heart disease.

目的总结电视胸腔镜下小儿先天性心脏病86例的手术经验，探讨电视胸腔镜在先天性心脏病治疗中的应用价值。方法经右侧胸壁3孔，股动脉、股静脉插管建立周围体外循环，用特制的长阻闭钳阻闭升主动脉，冷晶体心脏停跳液顺行灌注保护心肌。全胸腔镜下完成手术。结果体外循环时间（64±28）min，升主动脉阻闭时间（29±13）min，术后呼吸机辅助时间（3．2±1．1）h，术后住院时间（6．1±1．2）d。结论全胸腔镜下心脏手术创伤小，恢复快，疗效安全可靠。

Objective To summarize the experience in 86 cases of total thoracoscopy invasive operation on congenital heart disease. Methods Surgical procedures were performed through three lateral-right chest wall holes under thoracoseopy.An arterial catheter and a venous catheter were placed in the right femoral artery,femoral vein respectively to setup extracorporeal circulation.The ascending aorta was cross-clamped with a long specially-made forceps and the myocardium was protected by coronary perfusion with cold crystalloid cardiopleige.The surgical procedures were performed under total thoracoscopy. Results The durations of extracorporeal circulation and cross-clamped was （64 ± 28 ）min and （29 ± 13 ）min respectively,ventilation time （3.2 ± 1.1）h,markedly short postoperative hospital stay （6.1 ± 1.2）d. Conclusions total thoracoscopy surgery is technically feasible and safe, having minimal invasion, rapid recovery and good cosmetology effect.