分析电视胸腔镜下二尖瓣置换术应用于二尖瓣病变患者临床治疗的安全性

To Analyze the Clinical Safety of Video-assisted Mitral Valve Replacement in Patients with Mitral Valve Disease

目的:通过对比全胸腔镜二尖瓣置换患者及传统开胸二尖瓣置换患者手术时间、体外循环转机时间、住院时间、并发症发生率,测定全胸腔镜二尖瓣置换患者及传统开胸二尖瓣置换患者体外循环转机后静脉血中6-酮-前列腺素F1α(6-K-PGF1α)、B型钠尿肽前体(proBNP)、超敏肌钙蛋白T(hs-cTnT)水平,探讨电视胸腔镜下二尖瓣置换术应用于二尖瓣病变患者的临床治疗的安全性。方法:选择本院2018年1月~2020年12月收治的60例二尖瓣病变患者为研究对象,根据手术方法将患者分成观察组(n=30)和对照组(n=30)。对照组采用传统开胸二尖瓣置换术,观察组采用电视胸腔镜下二尖瓣置换术。结果:观察组体外循环时间、手术时间均长于对照组(P<0.05),但住院时间比对照组短(P<0.05),并发症发生率比对照组低(P<0.05),且观察组与对照组体外循环转机后6-K-PGF1α、proBNP、hs-cTnT水平差异无统计学意义(P>0.05)结论:全胸腔镜应用于二尖瓣置换手术虽然体外循环及手术时间较常规开胸组长,但并发症少,住院时间短,且体外循环转机后6-K-PGF1α、PROBNP、hs-cTnT水平差异无统计学意义,故胸腔镜二尖瓣置换术与传统开胸二尖瓣置换术相比安全性更高。

Objective:by comparing the total thoracoscope mitral valve replacement patients and traditional thoracotomy patients with mitral valve replacement surgery time and CPB time,hospitalization time,complication rate,and the levels of 6-keto-prostaglandin F1α(6-K-PGF1α),B-type natriuretic peptide precursor(proBNP),high-sensitivity troponin T(hs-cTnT)in venous blood after cardiopulmonary bypass,discusses the safety of mitral valve replacement under videoassisted thoracoscopy in the clinical treatment of patients with mitral valve disease.Methods:Sixty patients with mitral valve disease admitted in our hospital from January 2018 to December 2020 were selected as the research subjects,and the patients were divided into observation group(n=30)and control group(n=30)according to the surgical methods.The control group received conventional open-chest mitral valve replacement and the observation group received videoassisted mitral valve replacement.Results:The time of cardiopulmonary bypass and operation in the observation group were longer than those in the control group(P<0.05),but the hospitalization time was shorter than that in the control group(P<0.05),and the incidence of complications was lower than that in the control group(P<0.05).There was no statistical significance in the levels of 6-K-PGF1α,proBNP and hs-cTnT after cardiopulmonary bypass between the observation group and the control group(P>0.05).Conclusion:Although the cardiopulmonary bypass and operation time of thoracoscope mitral valve replacement are longer than conventional thoracotonmy group,but there are fewer complications,shorter hospitalization time,and there is no statistical significance in the levels of 6-K-PGF1α,proBNP and hs-cTnT.Therefore,thoracoscopic mitral valve replacement is safer than traditional open-thoracotomy mitral valve replacement.