完全胸腔镜微创手术治疗室间隔缺损的疗效分析

Efficacy of totally thoracoscopic surgery in repair of ventricular septal defect

目的分析完全胸腔镜与传统开胸行室间隔缺损修补术的临床效果。方法回顾性分析2015年1月至2017年1月我院50例室间隔缺损患者的临床资料。按手术方式分为两组:胸腔镜组21例,其中男13例、女8例,年龄(38.36±10.02)岁;传统开胸组29例,其中男18例、女11例,年龄(42.36±13.02)岁。比较两组患者手术时间、住院时间、呼吸机辅助时间、胸腔引流量等指标。结果两组患者均无死亡病例。对比传统开胸组,完全胸腔镜组体外循环时间及主动脉阻断时间延长(P<0.05),胸腔引流量及术后使用血制品的例数减少,住院时间缩短(P<0.05),两组手术时间、术后呼吸机辅助时间及住ICU时间差异无统计学意义(P>0.05)。结论与传统开胸比较,胸腔镜下室间隔缺损修补术安全可靠、创伤小、恢复快、节约用血,可作为外科干预的优先选择术式。

Objective To analyze the clinical efficacy of totally thoracoscopic surgery and conventional thoracotomy in repair of ventricular septal defect（VSD）.Methods We retrospectively reviewed the clinical data of 50 VSD patients admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2015 to January 2017.According to the surgical pattern,they were divided into two groups： a totally thoracoscopic surgery group（21 patients,13 males,8 females,aged 38.36±10.02 years）,and a thoracotomy group（29 patients,18 males,11 females,aged 42.36±13.02 years）.The operation time,hospital stay,ventilator-assisted time and thoracic drainage were compared between the two groups.Results There was no death in two groups.In the thoracoscopic group the duration of cardiopulmonary bypass（CPB） time and the aortic clamping time were longer than those of the thoracotomy group（P〈0.05）,but postoperative drainage,patients with postoperative use of blood products and postoperative hospital stay were less（P〈0.05）.There was no statistically significant difference between the two groups in operation time,postoperative ventilator-assisted time or duration of ICU stay.Conclusion Compared with the conventional thoracotomy,totally thoracoscopic VSD repair with less trauma,quicker recovery and less blood use,is safe and reliable and can be used as a preferred surgical intervention.