完全胸腔镜与传统开胸手术治疗先天性房间隔缺损的临床对比

摘要

Objective To explore the clinical effects of complete thoracoscopy versus traditional thoracotomy in the treatment of congenital atrial septal defect (ASD).Methods From January,2014 to January,2016,32 ASD patients treated with traditional thoracotomy at our hospital were selected as a control group.From January,2016 to January,2018,32 ASD patients treated with complete thoracoscopy were selected as an experimental group.The operation time,cardiac arrest time,aortic occlusion time,cardiopulmonary bypass time,blood product usage,chest drainage,and hospitalization were compared between the two groups.Quality of life (SF-36) and Hamilton anxiety scale (HAMA) were used to compare the quality of life and HAMA score between the two groups 3 months after operation.Results The operation time,cardiac arrest time,and aortic occlusion time,and the time of establishing cardiopulmonary bypass were shorter in the experimental group than in the control group (all P ＜ 0.05).The time of ICU treatment and the hospitalization time were shorter and the amount of blood product usage and the amount of chest cavity drainage were lower in the experimental group than in the control group (all P ＜ 0.05).The scores of SF-36 dimensions were higher and the HAMA score was lower in the experimental group than in the control group (all P ＜ 0.05).Conclusions Compared with traditional thoracotomy,total thoracoscopic surgery has the characteristics of less trauma,faster recovery,and less cardiac injury,and the long-term effect is better.%目的 探究完全胸腔镜与传统开胸手术治疗先天性房间隔缺损中的临床效果.方法 选取2014年1月至2016年1月本院未开展完全胸腔镜时使用传统开胸术进行治疗的32例ASD患者为对照组,选取2016年1月至2018年1月本院采取完全胸腔镜术进行治疗的32例ASD患者为实验组,对比两组手术时间、心脏停跳时间、主动脉阻断时间、体外循环建立时间、ICU治疗时间、血制品使用量、胸腔引流量、住院时间,并使用生活质量评定量表(SF-36)及汉密尔顿焦虑量表(HAMA)对两组患者术后3个月生活质量及HAMA得分进行对比.结果 实验组手术时间、心脏停跳时间、主动脉阻断时间、体外循环建立时间均短于对照组(均P＜ 0.05);实验组ICU治疗时间、血制品使用量、胸腔引流量、住院时间均低于对照组(均P＜ 0.05);术后3个月,实验组SF-36各维度得分高于对照组,HAMA得分低于对照组(均P＜ 0.05).结论 相比于传统开胸术,完全胸腔镜手术具有创伤小、术后恢复快、对患者心脏损伤小等特点,同时远期效果好于传统开胸术.