右胸前外侧微小切口二尖瓣置换术临床分析

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1、右胸前外侧微小切口二尖瓣置换术临床分析【摘要】目的比较右胸前外侧微小切口与正屮切口行二尖瓣置换术的临床疗效。方法回顾性分析2011年1月至2013年8月行右胸前外侧微小切口二尖瓣置换术88例（微创组）与同期行胸骨正中切口二尖瓣置换术102例（传统组）患者的临床资料，并比较。结果传统组死亡2例,微创组无死亡病例，两组患者术前资料（年龄、性别、体重、心胸比、体表面积、左室射血分数）的差异无统计学意义（P>0.05）；两组总手术时间、术后ICU停留时间的差异无统计学意义（P>0.05）；微创组体外循环时间及阻断时间要长于传统组（P<0.05）；微创组术后呼吸机辅助通气时间、术后一周切口长度均短于

2、传统组（P<0.05）,微创组术后心包、胸腔引流量要少于传统组（P〈0.05）。结论经右胸微小切口行二尖瓣置换术安全可行，具冇美容效果，疗效肯定。【关键词】微创手术；右胸前外侧小切口；二尖瓣置换术；体外循环TheclinicalanalysisofmitralvalvereplacementviarightanterolateralminithoracotomyLiuHong-duan,YuFeng-xu,LiXin,YangFan,DengMing-bin（DepartmentofCardiothoracicSurgery,TheAffiliatedHospitaiofLuzhouMed

3、icalCollege,Luzhou646000）Correspondingauthor：LiXin.E-mail：hongcluan@live.com.【Abstract】Objective：Tocomparethecliniceffectandsafetyofrightanterolateralminithoracotomyandmediansternotomyinthemitralvalvereplacement.MethodsTheclinicaldatafrom88patientsunderwentminimallyinvasivemitralvalvuereplacementv

4、iarightanterolateralminithoracotomy(minimallyinvasivegroup)and102patientsunderwentmediansternotomy(traditionalgroup)fromJanuary2011andAugust2013inourinstitutionwereretrespectivelyanalyzed.ResultsThereweretwodeathsintraditionalgroup,butnodeathsinminimallyinvasivegroup.Thereworenostatisticaldifferen

5、cesinthepreoperativedateandthetimeoftotaloperationandintensivecareunitstayinbothgroups(P>0.05).Thetimeofcardiopulmonarybypassandaorticcrossclampinminimallyinvasivegroupweresignificantlylongerthanthoseintraditionalgroup(P<0.05)・However,thepostoperativemechanicalventilationtime，thechesttubedrainagea

6、ndthepostoperativelengthofthethoracicincisionweresingnificantshorterinminimallyinvasivegroupthanthoseintraditionalgroup(P<0.05)•ConclusionMinimallyinvasivemitralvalvereplacementviarightanterolateralminithoracotomycanbeperformedsuccessfullyandbeachievingexcellentcosmeticandclinicalresults.[Keywords

7、]Minimallyinvasivesurgery；Rightminithoracotomy；MitralvalvereplacemerU；Carcliopu1monarybypass【中图分类号】R93【文献标识码】B【文章编号12095-6851(2014)2-0017-02胸骨正中切口行二尖瓣置换术(MitrialValveReplacement,MVR)是治疗二尖瓣病变较为经典和标准手术方式，而近年来随着医疗器械