在成人心脏手术中应用微创切口与常规切口的价值对比

Value of minimally invasive versus conventional incisions in adult cardia csurgery

目的:比较在成人心脏手术中应用微创切口与常规切口的价值。方法:对2019年11月至2021年5月于淮安市第一人民医院进行微创心脏外科手术的33例患者的临床资料进行回顾性分析。将其作为微创组。将该组患者分为胸骨径路组(做胸骨上半段、下半段、胸骨旁切口及小切口搭桥,使用常规手术器械)和胸腔镜组(使用胸腔镜及微创手术器械)。采用倾向性匹配法选取同期在该院进行胸骨正中切口心脏手术的33例患者作为常规组。对比各组患者的手术效果。结果:1)微创组33例患者均顺利完成手术,无中转开胸的患者。常规组患者及微创组患者中均无死亡的患者。2)微创组患者的切口长度、术后住院时间均短于常规组患者,其术后引流量少于常规组患者,差异有统计学意义(P<0.05)。胸骨径路组22例患者、胸腔镜组11例患者的手术总时间与常规组患者相比,差异无统计学意义(P>0.05)。结论:与常规切口相比,微创切口在成人心脏手术中的应用价值较高。

Objective:To compare the value of minimally invasive incision and conventional incision in adult cardiac surgery.Methods:The clinical data of 33 patients who underwent minimal ly invasive cardiac surgery in Huai'an First People’s Hospital from November 2019 to May 2021 were retrospectively analyzed.Consider it a minimally invasive group.Patients in this group were divided into the sternal approach group(upper and lower sternal incisions,parasternal incision and small incision bypass,using conventional surgical instruments)and the thoracoscopic group(thoracoscopic and minimally invasive surgical instruments).A total of 33 patients undergoing median sternal incision heart surgery in this hospital were selected as the routine group.The surgical results of each group were compared.Results:1)All the 33 patients in the minimally invasive group successfully completed surgery,and no patients were transferred to thoracotomy.There were no deaths in the conventional or minimally invasive groups.2)The incision length and postoperative hospital stay in the minimally invasive group were shorter than those in the conventional group,and the postoperative drainage was less than that in the conventional group,with statistically significant differences(P<0.05).The total operation time of 22 patients in the sternal path group and 11 patients in the thoracoscopic group was not significantly different from that of the conventional group(P>0.05).Conclusion:Compared with conventional incision,minimally invasive incision has higher application value in adult cardiac surgery.