电视胸腔镜在胸心外科临床应用76例报告

目的　总结分析 76例电视胸腔镜胸心外科手术。　方法　手术方法包括 :动脉导管钳闭 ;纵隔肿瘤 ,胸交感神经切除 ;肺、胸膜 ,纵隔淋巴结活检 ;肺大泡、自发性气胸治疗 ;外伤性血胸 ,自发性血胸 ,不明原因胸腔积液探查 ;胸膜固定术 ;心包开窗引流 ;包裹性脓肿清除。　结果　电视胸腔镜 PDA钳闭病例 ,彩色超声心动图复查均无残余分流 ,术后最长已随访 2年 ,未发现再通现象。纵隔肿瘤成功地在电视胸腔镜下摘除。原发性长 QT综合征左 T2 、T3交感神经节广泛切除后 ,术后即刻 QT间期即从 0 .6 0 s缩短为 0 .42 s,术后再未出现室性心动过速和昏厥现象。重症雷诺病患者行双侧胸交感神经节切除后 ,末梢循环得到显著改善 ;自发性气胸治疗多数术后仅留置闭式引流 2～ 4天 ;纵隔淋巴结活检为准确病理诊断提供了新手段。　结论　电视胸腔镜下动脉导管钳闭等手术安全可靠、创伤小 ,值得进一步应用和完善。

Video-assisted Thoracoscopic Surgical Technique in Cardiothoracic Surgery(Report of 76 Cases)

Objective\ The purpose of this study is to analyse the clinical results of 76 cases who underwent video\|assisted thoracoscopic surgery.\ Methods\ the video\|assisted surgical techniques included: interrupting patent ductus arteriosus; excising mediastinal tumors and sympathectomy; biopsy of lung, pleural and lymph nodes; treating bullae of lung and spontaneous pneumothorax; exploration of thoracic trauma, bleeding and unknown pleural effusion; pleurodesis; debriding encapsulated pyothorax. Results\ There was no any residual or recurrent shunt after interruption of patent ductus arteriosus, even after a two\|year follow\|up.\ All the mediastinal tumors were successfully excised except one, which needed a 3 cm incision.\ The idiopathic long QT patient recovered very well after left T\-2 and T\-3 sympathectomy, with the QT interval from 0 60 to 0 42.\ The peripheral circulation was well improved in the Raynaud\|disease patient after bilateral thoracic sympathectomy.\ The patients with lung bullae and pneumothorax were successfully treated after debridement of the bullae and 2 to 4 days chest drainage. \ Mediastinal lymph nodes biopsy provided a new and precise method for pathology diagnosis.\ Conclusion Video\|assisted thoracoscopic surgery is proved being a minimally invasive, safe and reliable surgical technique.