CAJ | 학술논문

目的总结全胸腔镜下二尖瓣置换手术55例成功经验.方法采用右胸壁打孔,股动脉、股静脉插管建立周围体外循环,阻闭升主动脉,冷血停跳液顺行灌注保护心肌,全胸腔镜下行二尖瓣置换手术.结果手术均获成功,无死亡.手术3.6～5.6 h,平均(4.6±1.0)h.体外循环90～146 min,平均(118±28) min,升主动脉阻断55～85 min,平均(70±15) min;术后呼吸机辅助9.2～16.4 h,平均(10.2±3.1) h;胸液引流量80～350 ml,平均(72±28) ml;住院10～16 d,平均(13±3) d.结论全胸腔镜下二尖瓣置换手术安全可靠、创伤小、恢复快、美容效果好.
목적 총결전흉강경하이첨판치환수술55례성공경험.방법 채용우흉벽타공,고동맥、고정맥삽관건립주위체외순배,조폐승주동맥,랭혈정도액순행관주보호심기,전흉강경하행이첨판치환수술.결과 수술균획성공,무사망.수술3.6～5.6 h,평균(4.6±1.0)h.체외순배90～146 min,평균(118±28) min,승주동맥조단55～85 min,평균(70±15) min;술후호흡궤보조9.2～16.4 h,평균(10.2±3.1) h;흉액인류량80～350 ml,평균(72±28) ml;주원10～16 d,평균(13±3) d.결론 전흉강경하이첨판치환수술안전가고、창상소、회복쾌、미용효과호.
Objective To summarize the experience in 55 cases of total thoracoscopicy operations in mitral valve replacement.Methods 55 selected patient's surgical procedures were performed through three lateral-right chest wall holes under thoracoscopy.An arterial catheter and a venous catheter were placed in the right femoral artery,femoral vein respectively to setup extracorporeal circulation.The ascending aorta was cross-clamped with a long specially-made forceps and the myocardium was protected by coronary perfusion with cold crystalloid cardiopleige.The procedures of mitral valve replacement were performed under total thoracoscopicy.Results All the operations were successful,there was no death case.The durations of operation and extracorporeal circulation was 3.6-5.6(4.6±1.0)h,90-146(118±28)min respectively,cross-clamped time 55-85(70±15)min,ventilation time 9.2-16.4(10.2±3.1)h,total chest tube drainage 80-350(72±28)ml,postoperative hospital stay 10-16(13±3)d.Conclusion Total thoracoscopicy surgery in mitral valve replacement is technically feasible and safe,having minimal invasion,rapid recovery and good cosmetology effect.