26例胸腔镜辅助下微创二尖瓣手术的临床观察

Minimal invasive mitral valve surgery under thoracoscopy:Clinical observation of 26 patients

胸腔镜辅助下二尖瓣手术26例(胸腔镜组),同期常规正中开胸二尖瓣手术30例(常规组),两组均无死亡病例,两组术后呼吸机辅助时间、术前左房内径及左室射血分数差异无统计学意义,胸腔镜组主动脉阻断时间及体外循环时间较常规组长(P<0.05),而胸腔镜组术后24 h胸液量明显减少(P<0.05),术后ICU监护时间、住院时间明显缩短(P<0.05),且胸腔镜组术后左房内径及左室射血分数较常规组明显改善(P<0.05),术后肺动脉压力下降也较常规组明显(P<0.05)。

There were 26 patients in thoracoscopy group for which the mitral valves were repaired or replaced with video-assisted mini incision technique, and 30 patients in conventional group with conventional surgical technique. There was no mortality in both groups and no significant differences in the postoperative mechanical ventilation time, preoperative left atrial diameter and left ventricular ejection fraction. As compared with the conventional group, the thoracoscopy group had longer aortic cross-clamping time and cardiopulmonary bypass time, less chest drainage of 24 hours after surgery and significantly shorter days of postoperative intensive care unit and hospital stay. The postoperative left atrial diameter and left ventricular ejection fraction of thoracoscopy group improved significantly with significantly decreased postoperative pulmonary artery pressure.