快通道胸腔镜简单心脏手术的临床观察

Application of fast channel thoracoscopic in simple cardiac surgery

目的 总结快通道胸腔镜心脏手术治疗简单心脏病的临床经验.方法 对2012年6月至2013年6月我院简单心脏病患者22例行快通道胸腔镜心脏手术,术中行快通道麻醉拔管,术后行综合管理.结果 快通道胸腔镜心脏手术时间3.5～6.5 h,平均4.5 h;主动脉阻断时间25～72 min,平均34 min;出血量30～260 ml,平均63 ml;意识清醒时间10～360 min,平均25 min;30 min后肌力恢复3级以上占90％;呼吸机辅助时间12～40 min,平均29 min;气管插管拔除时间术后30～120 min,平均75 min;住院4～12 d,平均6.5 d;住院费用总计2.5～4.5万元,平均2.8万元.结论 胸腔镜心脏手术、快通道麻醉、体外循环、术后管理各环节之间应达到无缝连接,保证快通道技术顺利完成.

Objective To observe the effect of fast channel thoracoscopic cardiac surgery technology in a simple treatment of heart disease.Methods Simple heart attack patients in our hospital treat with fast channel thoracoscopic cardiac surgery from June 2012 to June 2013,with fast channel intraoperative anesthesia extubation,and with integrated management of postoperative.Results The operation time 3.5-6.5 hours （mean 4.5 hours）,aortic clamping time 25-72 min（average 34 min）,blood loss 30-260 ml（average 63 ml）,conscious time 10-360 min （average 25 min）,30 min muscle recovery after three or more accounted for 90 percent strength,ventilation time 12-40 min （average 29 min）,intubation time after removal 30-120 min （average 75 min）,length of stay 4-12 days（average 6.5 days）,total hospital costs 25 000-45 000 RMB yuan（average 28 000 yuan）.Conclusion Thoracoscopic cardiac surgery,should achieve a seamless connection between the fast-track anesthesia,cardiopulmonary bypass,postoperative management,ensure the successful completion of fast-track technology.