CAJ | 학술논문

目的：根据中国心血管外科注册登记研究数据，分析中国心血管外科微创技术的应用现状和未来发展。 　　方法：中国心血管外科注册登记研究组包括全国19个省市45家协作医院。2010-09至2012-03阜外心血管病医院及所有协作医院共收集成人心血管外科病例16480例，分为常规手术组14503例（92.5%）和微创手术组1977例（7.5%）。通过对资料进行分析，以期了解我国的微创心血管外科的现状和未来的走向。 　　结果：从纳入患者的基线资料可见，微创手术组比常规手术组年龄偏小，术前一般情况较好，病情较稳定。微创手术组中复合手术方式与另外四种微创手术相比更能够明显缩短体外循环时间、主动脉阻断时间、重症监护时间、住院时间、呼吸机使用时间和减少术后引流量，同时（除与机器人手术比外）能够明显减少术中和术后红细胞、血浆的使用（P均<0.01）。接受微创手术患者中有12例（0.6%）出现院内死亡，总体并发症发生率为4%。 　　结论：微创心血管外科技术在国内越来越多地得到应用，其短期安全性和有效性值得肯定，未来随着心血管疾病谱的改变，微创技术的方式和治疗的病种也会发生改变。
목적：근거중국심혈관외과주책등기연구수거，분석중국심혈관외과미창기술적응용현상화미래발전。 　　방법：중국심혈관외과주책등기연구조포괄전국19개성시45가협작의원。2010-09지2012-03부외심혈관병의원급소유협작의원공수집성인심혈관외과병례16480례，분위상규수술조14503례（92.5%）화미창수술조1977례（7.5%）。통과대자료진행분석，이기료해아국적미창심혈관외과적현상화미래적주향。 　　결과：종납입환자적기선자료가견，미창수술조비상규수술조년령편소，술전일반정황교호，병정교은정。미창수술조중복합수술방식여령외사충미창수술상비경능구명현축단체외순배시간、주동맥조단시간、중증감호시간、주원시간、호흡궤사용시간화감소술후인류량，동시（제여궤기인수술비외）능구명현감소술중화술후홍세포、혈장적사용（P균<0.01）。접수미창수술환자중유12례（0.6%）출현원내사망，총체병발증발생솔위4%。 　　결론：미창심혈관외과기술재국내월래월다지득도응용，기단기안전성화유효성치득긍정，미래수착심혈관질병보적개변，미창기술적방식화치료적병충야회발생개변。
Objective: Based on nationwide cardiovascular surgery registry database, to analyze the current status and future development of minimally invasive cardiovascular surgery (MICS) in China. Methods: There were 45 institutions from 19 provinces nationwide involved in Chinese cardiovascular surgery technique registry study. A total of 16480 adult patients with cardiovascular surgery from 2010-09 to 2012-03 were divided into 2 groups, Conventional surgery group, n=14503 and MICS group, n=1977. The basic clinical conditions were analyzed and compared between 2 groups in order to explore the current status and future development of MICS in China. Results: Compared with Conventional surgery group, the patients in MICS group had the younger age, better and stable pre-operative condition. In MICS group, compared with 4 other common procedures, the patients who received hybrid procedure had obviously shorter cardiopulmonary bypass (CPB) time, aortic occlusion time, ventilator using time, ICU and in-hospital stay time, meanwhile decreased post-operative drainage volume;except for Robotic surgery, it required less red blood cells and plasma at during and post-operative time, all P<0.01. There were 12 (0.6%) in-hospital death in MICS group, the total complication rate was at 4%. Conclusion: MICS are widely used in China, its short-term safety and efifcacy are conifrmed. Upon cardiovascular disease spectrum changing, the MICS procedures will be adjusted accordingly.