胸腔镜结合右胸前外侧微创切口在二尖瓣置换术中的应用价值分析

Analysis of the value of thoracoscopy combined with right anterolateral minimally invasive incision in mitral valve replacement

目的探讨二尖瓣置换术中实施胸腔镜下右胸前外侧微创切口的临床价值。方法以随机数字表法将86例行二尖瓣置换术患者分为观察组43例,对照组43例,观察组行胸腔镜下右胸前外侧微创切口,对照组行胸正中切口,观察两组治疗效果,比较术中及术后相关指标及术后并发症发生情况。结果 2组均顺利完成手术,未出现死亡病例,术后复查心脏彩超显示人工心脏瓣膜功能良好;观察组术中出血量、胸腔引流量明显少于对照组(P<0.05);观察组术后ICU停留时间、术后住院时间明显短于对照组(P<0.05),观察组手术时间长于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率为4.65%,对照组术后并发症发生率为9.30%,2组差异无统计学意义(P>0.05),患者均未出现严重并发症。结论二尖瓣置换术中实施胸腔镜下右胸前外侧微创切口,效果满意,可减少术中出血及胸腔引流,缩短术后恢复时间,且安全性高,值得推广。

ObjectiveTo investigate the clinical value of minimally invasive thoracoscopic right anterolateral incision in mitral valve replacement.MethodsA total of 86 patients undergoing mitral valve replacement were randomly divided into the observation group(43 cases)and the control group(43 cases).The thoracoscopic lateral right chest anterior minimally invasive incision was conducted in observation group.The median chest incision was conducted in control group.The therapeutic effects,intraoperative and postoperative related indicators,postoperative complications were observed in two groups of patients.ResultsBoth groups were successfully completed the operation,no death case,postoperative echocardiography showed that the artificial heart valve function was good.The bleeding volume,thoracic drainage volume,ICU stay time and hospitalization time in the observation group were significantly less than those in the control group(P<0.05).The incidence of complications in the observation group and the control group were 4.65%and 9.30%,respectively(P>0.05).No serious complications occurred in the control group.ConclusionIn mitral valve replacement,the minimally invasive incision on the lateral side of the right chest under the thoracoscopy has a satisfactory effect,which can reduce intraoperative bleeding and thoracic drainage,shorten postoperative recovery time,and has a high safety,which is worthy of promotion.