电视胸腔镜微创体外循环心脏手术与常规手术方法比较

【目的】探讨电视胸腔镜微创体外循心内直视术治疗先天性心脏病房间隔缺损的手术方法和效果。【方法】将80例房间隔缺损的先心病患者分成2组，电视胸腔镜组（A组）：40例，采用胸壁打孔股动脉、股静脉和上腔静脉插管，建立体外循环。常规组（B组）：40例，采用正中纵劈胸骨，经主动脉、上下腔静脉插管建立体外循环。【结果】胸腔镜组较常规组创伤小，术后24h胸腔引流量小（P〈0．01），手术辅助呼吸时间短（P〈0．05），手术应用库血量少（P〈0．05），ICU停留时间短（P〈0．01）。【结论】电视胸腔镜微创体外循环下心内直视术创伤小，恢复快，手术并发症少，安全可行。

Comparison on video assisted and conventional cardiac surgical method

Objective] To investigate the surgical technique and clinical results of congenital atrial septal defect with video assisted thoracic in micro-cardiopulmonary bypass （CPB）. Methods ] Eighty atria septal defect cases were divided into two groups. In the VATO group （A）, fourty cases were adopted opening holes in thorax, the arterial catheter and one venous catheter were placed in the right femoral artery and femoral vein, the other venous catheter was placed in the superior vena cave to set up CPB. In conventional group （B）, forty cases the breast bone was opened from up to down. The arterial catheter and two venous catheter were placed in the aortic, the superior vena cava and interior vena cava to set up CPB. Results] In the VATO technique the wound was remarkably alleviated , the chest drainage （ml） in the first 24hr was fewer （P 〈 0.01）, the time of the mechanical respiration was shorter （P 〈 0.05）, the ammount of blood supplied was fewer （ P 〈 0.05）; and the time of ICU was shorter stay （ P 〈 0.01） . Conclusions] The open heart operation with minimally invasive VATO assisted technique remarkably alleviated the wounds, decrease recovery time and complications. It is a safety and dependable technique for repairing atrial septal defect.