胸腔镜辅助下主动脉瓣置换术临床分析_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

贾宝成 ,  程云阁 , 兰怀 , 阿曼姑丽·苏力坦

上海远大心胸医院腔镜科（上海 200235）;

Corresponding author：

Keywords：

胸腔镜; 心脏瓣膜疾病; 主动脉瓣置换术; 外科手术; 微创性

DOI：

10.7507/1007-4848.20150101

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的总结经右胸骨旁第2肋上缘至第3肋下缘斜切口行胸腔镜辅助下主动脉瓣置换术的临床经验。方法回顾性分析2012年9月至2014年2月上海远大心胸医院腔镜科施行手术治疗38例单纯主动脉瓣病变患者的临床资料，其中男25例、女13例，年龄32～58（46±13）岁。先天性主动脉瓣二瓣化畸形12例，风湿性病变22例，退行性病变4例，均采用全身麻醉双腔气管内插管，股动、静脉插管建立体外循环，经右胸骨旁第2肋上缘至第3肋下缘斜切口行胸腔镜辅助下主动脉瓣置换术。结果全组患者术后恢复良好，均治愈出院。全组平均手术时间、体外循环时间、主动脉阻断时间分别为（184±28）min、（83±21）min、（58±16）min。术后平均机械通气时间为（8±4）h。术后住ICU时间和住院时间分别为（26±12）h和（8±5）d。术后24 h平均胸腔引流量为（350±296）ml。本组2例患者因主动脉瓣环偏小需延长手术切口以改善手术术野；1例患者术后引流量较多再次开胸止血；术中无中转开胸患者。其他并发症包括切口愈合不良2例（5.3%），胸腔积液及气胸各1例（2.6%）。结论经右胸骨旁第2肋上缘至第3肋下缘斜切口完成胸腔镜辅助下主动脉瓣置换术术野显露良好，美容效果好，患者术后恢复快，临床可选择性应用。

Citation： 贾宝成, 程云阁, 兰怀, 阿曼姑丽·苏力坦. 胸腔镜辅助下主动脉瓣置换术临床分析. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(4): 385-387. doi: 10.7507/1007-4848.20150101 Copy

1.	程云阁, 俞世强, 康云帆, 等.完全内窥镜下的房室间隔缺损修补术.医师进修杂志, 2003, 26(8):202-203.
2.	程云阁, 王跃军, 顾剑民, 等.全胸腔镜下二尖瓣置换术临床经验总结.岭南心血管病杂志, 2007, 13(10):321-323.
3.	程云阁, 王跃军, 顾剑民, 等.完全胸腔镜下体外循环心脏手术674例临床分析.中华外科杂志, 2007, 45(22):1521-1523.
4.	Brown ML, McKellar SH, Sundt TM, et al.Ministernotomy versus conventional sternotomy for aortic valve replacement:a systematic review and meta-analysis.J Thorac Cardiovasc Surg, 2009, 137(3):670-679.
5.	Cosgrove DM 3rd, Sabik JF.Minimally invasive approach for aortic valve operations.Ann Surg, 1996, 62(2):596-597.
6.	Kaur S, Balaguer J, Vander Salm TJ.Improved myocardial protection in minimally invasive aortic valve surgery with the assistance of port-access technology.J Thorac Cardiovasc Surg, 1998, 116(5):874-875.
7.	Aybek T, Dogan S, Wimmer-Greinecker G, et al.The micro-mitral operation comparing the Port-Access technique and the transthoracic clamp technique.J Card Surg, 2000, 15(1):76-81.
8.	Tabata M, Umakanthan R, Cohn LH, et al.Early and late outcomes of 1000 minimally invasive aortic valve operation.Eur J Cardiothorac Surg, 2008, 33(4):537-541.
9.	Mihaljevic T, Cohn LH, Unic D, et al.One thousand minimally invasive valve operations:early and late results.Ann Surg, 2004, 240(3):529-534.
10.	Tabata M, Umakanthan R, Khalpey Z, et al.Conversion to full sternotomy during minimal-access cardiac surgery:reasons and results during a 9.5-year experience.J Thorac Cardiovasc Surg, 2007, 134(1):165-169.

1. 程云阁, 俞世强, 康云帆, 等.完全内窥镜下的房室间隔缺损修补术.医师进修杂志, 2003, 26(8):202-203.
2. 程云阁, 王跃军, 顾剑民, 等.全胸腔镜下二尖瓣置换术临床经验总结.岭南心血管病杂志, 2007, 13(10):321-323.
3. 程云阁, 王跃军, 顾剑民, 等.完全胸腔镜下体外循环心脏手术674例临床分析.中华外科杂志, 2007, 45(22):1521-1523.
4. Brown ML, McKellar SH, Sundt TM, et al.Ministernotomy versus conventional sternotomy for aortic valve replacement:a systematic review and meta-analysis.J Thorac Cardiovasc Surg, 2009, 137(3):670-679.
5. Cosgrove DM 3rd, Sabik JF.Minimally invasive approach for aortic valve operations.Ann Surg, 1996, 62(2):596-597.
6. Kaur S, Balaguer J, Vander Salm TJ.Improved myocardial protection in minimally invasive aortic valve surgery with the assistance of port-access technology.J Thorac Cardiovasc Surg, 1998, 116(5):874-875.
7. Aybek T, Dogan S, Wimmer-Greinecker G, et al.The micro-mitral operation comparing the Port-Access technique and the transthoracic clamp technique.J Card Surg, 2000, 15(1):76-81.
8. Tabata M, Umakanthan R, Cohn LH, et al.Early and late outcomes of 1000 minimally invasive aortic valve operation.Eur J Cardiothorac Surg, 2008, 33(4):537-541.
9. Mihaljevic T, Cohn LH, Unic D, et al.One thousand minimally invasive valve operations:early and late results.Ann Surg, 2004, 240(3):529-534.
10. Tabata M, Umakanthan R, Khalpey Z, et al.Conversion to full sternotomy during minimal-access cardiac surgery:reasons and results during a 9.5-year experience.J Thorac Cardiovasc Surg, 2007, 134(1):165-169.

Previous Article
努力提高我国腹腔镜胃癌手术水平的几点思考
Next Article
努力提高我国腹腔镜胃癌手术水平的几点思考

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

胸腔镜辅助下主动脉瓣置换术临床分析

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content