双孔法全胸腔镜技术置换二尖瓣的可行性

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摘要目的探讨双孔法全胸腔镜技术置换二尖瓣的安全可行性。方法回顾性分析首都医科大学附属北京朝阳医院心外科2015年1月至2016年12月收治的90例二尖瓣狭窄患者的临床资料。36（40%）例行双孔法全胸腔镜二尖瓣置换，为双孔法全胸腔镜组；54例行常规开胸二尖瓣置换，为常规开胸组。两组围手术期变量与术后1年的随访资料进行分析。结果 23例（25.5%）患者同期三尖瓣成形术。两组总手术时间、体外循环时间、心肌血运阻断时间比较，差异无统计学意义（P ＞ 0.05）；双孔法全胸腔镜组平均机械通气时间短于常规开胸组（P ＜ 0.05）；双孔法全胸腔镜组胸管引流量少于常规开胸组（P ＜ 0.05）。常规开胸组有1例二次开胸（1.8%）。两组患者术后1年随访，无死亡病例、瓣周漏、感染性心内膜炎、肺部并发症。结论双孔法全胸腔镜二尖瓣置换手术早中期结果安全有效。

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	陈瑛琪1 刘岩2 顾松2 苏丕雄2 高杰2▲

关键词 ：全胸腔镜, 双孔法, 二尖瓣狭窄, 二尖瓣置换术

Abstract：Objective To investigate the safety and feasibility of double-hole total thoracoscopic mitral valve replacement with double orifice. Methods The clinical data of 90 patients with mitral stenosis admitted to Department of Cardiac Surgery, Beijing Chaoyang Hospital Capital Medical University from January 2015 to December 2016 were retrospectively analyzed. A total of 36 (40%) patients underwent complete thoracoscopic mitral valve replacement by double-hole total thoracoscopic approach. Fifty-four patients underwent conventional thoracotomy for mitral valve replacement. Perioperative variables and one year postoperative follow-up data were analyzed. Results Twenty-three patients (25.5%) underwent tricuspid valvuloplasty at the same time. There were no significant differences in total operation time, cardiopulmonary bypass time and myocardial blood supply blockade time between the two groups (P ＞ 0.05). The mean mechanical ventilation time of the total thoracoscopy group was shorter than that of the conventional thoracotomy group (P ＜ 0.05). The drainage volume of thoracoscopic thoracoscopy was less than that of conventional thoracotomy group (P ＜ 0.05). In the conventional thoracotomy group, one patient had secondary thoracotomy (1.8%). There were no deaths, perivalvular leakage, infective endocarditis, or pulmonary complications in one year of follow-up in both groups. Conclusion The double-hole total thoracoscopic approach for mitral value replacement is safe and feasible.

Key words： Total thoracoscopic Approach Double-hole Mitral stenosis Mitral valve replacement

基金资助:北京市医院局临床技术创新项目（XMLX201312）。

通讯作者: ▲通讯作者

引用本文:

陈瑛琪1 刘岩2 顾松2 苏丕雄2 高杰2▲. 双孔法全胸腔镜技术置换二尖瓣的可行性[J]. 中国医药导报, 2021, 18(31): 108-110,114.
CHEN Yingqi1 LIU Yan2 GU Song2 SU Pixiong2 GAO Jie2▲. Feasibility of double-hole total thoracoscopic approach for mitral valve replacement #br#. 中国医药导报, 2021, 18(31): 108-110,114.

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https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2021/V18/I31/108

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