胸腔镜下心脏外科手术并发症的分析及预防

Analysis and prevention of complications in thoracoscopic cardiac surgery

目的 分析胸腔镜心脏手术围手术期的并发症及意外情况.方法 采用经股动、静脉插管,体外循环下全电视胸腔镜心脏手术对心脏病患者进行治疗,对治疗过程中出现的意外情况及并发症进行详细记录、观察、分析,并讨论相应预防及处理措施.结果 105例患者中出现了以下并发症：低氧高碳酸血症2例,周围体外循环泵压高、灌注流量不足2例,升主动脉夹层1例,主动脉出血1例,乳内动静脉损伤1例,血气胸2例,股动脉狭窄2例,股神经卡压、损伤1例.经术中相应补救措施、术后妥善治疗后并发症得以缓解或痊愈,均得到了有效控制.结论 经股动、静脉插管,体外循环下全电视胸腔镜心脏手术是安全有效的,其术中、术后可能出现的并发症及意外情况是完全可防可治的.

Objective To discuss and analyze the perioperative complications and accidents in our thoracoscopic cardiac surgery. Methods Recording, observing and analyzing the perioperative complications and accidents in the therapeutic process of thoracoscopic cardiac operation with femoral artery and vein bypass, and dis- cussing the appropriate prevention and treatment measures. Results The perioperative complications and accidents in 105 patients including 2 patients with hypoxia and hypercapnia, 2 patients with high pressure of cardiopulmonary bypass and insufficient flow perfusion, 1 patient with ascending aortic dissection, 1 patient with aortic bleeding, 1 patient with internal mammary artery and vein injury, 2 patients with hemopneumothorax, 2 patients with femoral artery stenosis, 1 patient with femoral nerve injury. Conclusion Thoracoscopic cardiac operation with femoral artery and vein bypass is safe and effective, the perioperative complications and accidents are completely preventable and curable.