心脏跳动中微创二尖瓣置换术58例

摘要

Objective To evaluate the clinical efficacy of minimally invasive beating-heart mitral valve replacement in patients diagnosed with heart valvular disease.Methods A total of 116 patients diagnosed with heart valvular disease were randomly assigned into the control (odd hospitalization ID) and observation groups (even hospitalization ID).In the control group, 58 patients underwent routine trans-sternal surgery during heart beating, and 58 counterparts in the observation group received minimally invasive beating-heart mitral valve replacement.At postoperative 2 weeks, surgical parameters including cardiopulmonary bypass time, operation time, length of hospital stay, intraoperative blood transfusion volume and the incidence of postoperative complications including ventricular fibrillation, low cardiac output syndrome, hemoglobinuria and pulmonary infection were observed and statistically compared between two groups.Results In the observation group, cardiopulmonary bypass time, operation time, length of hospital stay were significantly shorter, and intraoperative blood transfusion volume was considerably less compared with those in the control group (all P<0.01).The incidence of postoperative complications in the observation group was 6.90%, remarkably lower than 27.59% in the control group (P<0.05).Conclusions Application of minimally invasive beating-heart mitral valve replacement can shorten the cardiopulmonary bypass time, operation time and length of hospital stay, reduce intraoperative blood loss and decrease the risk of postoperative complications.%目的 探讨心脏跳动中微创二尖瓣置换术的临床应用效果.方法 116例心脏瓣膜病患者按照患者住院单双号,随机分为对照组(住院号单号)与观察组(住院号双号).对照组58例,实施心脏跳动中经胸骨正中常规手术.观察组58例,实施心脏跳动中微创二尖瓣置换术.手术完成后第2周比较2组患者手术观察指标(体外循环时间、手术时间、住院天数、术中输血量)及并发症发生率(心室颤动、低心排综合征、血红蛋白尿、肺部感染).结果 观察组体外循环时间、手术时间、住院天数均短于对照组,术中输血量少于对照组,差异均有统计学意义(P均<0.01).观察组并发症发生率(6.90%)低于对照组(27.59%),差异有统计学意义(P<0.05).结论 心脏跳动中微创二尖瓣置换术可缩短心脏瓣膜病患者体外循环时间、手术时间、住院天数,减少术中输血量,降低并发症发生率.