腔镜辅助右侧单孔与正中切口下二尖瓣成形手术的临床对比

Clinical comparison of laparoscopic assisted right single incision versus sternotomy approach for mitral valvuloplasty

目的比较腔镜辅助右侧单孔和传统正中开胸下二尖瓣成形术的临床结果。方法2015年10月至2019年10月,我院行腔镜辅助右侧单孔下二尖瓣成形手术22例(微创组),选择本手术组同期经正中开胸切口下单纯二尖瓣成形手术20例(常规组),分别对两组患者的瓣膜成形手术的相关指标、术后恢复及并发症发生情况加以对比。结果微创组二尖瓣成形手术的主动脉阻断时间及体外循环时间均较常规组长(P<0.05),成形手术时间延长更为明显,两组患者瓣膜成形效果均满意。微创组术后24 h胸液引流量明显减少(P<0.05),术后呼吸机辅助通气时间、ICU监护时间及住院时间也明显缩短(P<0.05)。结论腔镜辅助右侧单孔下行二尖瓣成形手术与传统正中切口下手术疗效相当,但创伤小、出血少,术后康复较快,具有临床推广价值。

Objective To compare the clinical outcomes of mitral valvuloplasty between laparoscopic assisted right single incision with traditional median thoracotomy.Method From October 2015 to October 2019,22 patients(minimally invasive group)received laparoscopic assisted right single incision mitral valvuloplasty,20 patients(conventional group)were selected for the median thoracotomy incision in in the same period,data on postoperative recovery and complications between the two groups were compared.Result The aortic cross-clamping time and cardiopulmonary bypass time in the minimally invasive group was longer than that of the conventional group(P<0.05),but the 24 h pleural fluid drainage volume and postoperative mechanical ventilation time were significantly reduced(P<0.05),ICU monitoring time and hospital days were also significantly shorter than those of the conventional group(P<0.05).Conclusion The clinical outcome of laparoscopic assisted right single incision mitral valvuloplasty is equivalent to traditional median incision surgical treatment,and it’s featured by lesser injury,less bleeding and quicker recovery,which is worthy of clinical application.