右側腋下直切口在二次心臟瓣膜手術中的應用_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

王強 , 李凱 , 潘俊 , 曹海龍 , 范阜東 , 周慶 ,  王東進

南京大學醫學院附屬鼓樓醫院心胸外科（南京 210008）;

Corresponding?author：

王東進, Email: gldjw@163.com

Keywords：

右腋下直小切口; 二次心臟手術; 瓣膜手術

DOI：

10.7507/1007-4848.201706024

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目的探討右側腋下直切口在二次心臟瓣膜手術中的應用效果。方法回顧性分析2014 年 1 月至 2016 年 12 月我院經右側腋下直切口行二次心臟瓣膜手術 23 例患者的臨床資料，男 9 例、女 14 例，年齡 37～67 歲，平均（54.0±9.1）歲，體重 43～73 （56.0±9.8）kg。手術方式包括二尖瓣置換（MVR）7 例，二尖瓣成形（MVP）1 例，主動脈瓣置換（AVR）3 例，三尖瓣成形術（TVP）4 例，三尖瓣置換術（TVR）2 例，MVR+TVP 2 例。結果本組平均手術時間 3～6（4.6±0.9）h，體外循環時間 55～140（104.8±22.3） min。心臟停跳術后自動復跳 17 例（17/23），氣管插管時間 4～24（12.2±6.0）h，手術后住院時間平均（7.5±1.9）d。手術后首日引流量平均（404.3±204.0）ml。17 例患者術后無輸血（17/23）。本組患者無圍術期死亡，無明顯并發癥出現。出院時心功能 Ⅰ 級 13 例、Ⅱ 級 10 例。結論經右側腋下直切口在二次心臟瓣膜手術中的近期手術效果良好，手術安全性高，適用于常見二次心臟瓣膜手術。

Citation： 王強, 李凱, 潘俊, 曹海龍, 范阜東, 周慶, 王東進. 右側腋下直切口在二次心臟瓣膜手術中的應用. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(6): 536-538. doi: 10.7507/1007-4848.201706024 Copy

1.	Head SJ, ?elik M, Kappetein AP. Kappetein. Mechanical versus bioprosthetic aortic valve replacement. Eur Heart J, 2017, 38(28):2183-2191.
2.	李平, 尤斌, 高峰, 等. 經右胸小切口在二次心臟手術中的應用. 心肺血管病雜志, 2015, 34(6): 465-469.
3.	Celiento M, Blasi S, De Martino A, et al. The mosaic mitral valve bioprosthesis: A long-term clinical and hemodynamic follow-up. Tex Heart Inst J, 2016, 43(1): 13-19.
4.	Wang H, Liu X, Wang X, et al. Comparison of outcomes of tricuspid annuloplasty with 3D-rigid versus flexible prosthetic ring for functional tricuspid regurgitation secondary to rheumatic mitral valve disease. J Thorac Dis, 2016, 8(11): 3087-3095.
5.	Onorati F, Perrotti A, Reichart D, et al. Surgical factors and complications affecting hospital outcome in redo mitral surgery: insights from a multicentre experience. Eur J Cardiothorac Surg, 2016, 49(5): e127-e133.
6.	王瀟, 陶涼, 陳緒發, 等. 右胸微創小切口二尖瓣置換術與傳統二尖瓣置換術的對比分析. 中國胸心血管外科臨床雜志, 2013, 20 (2): 139-143.
7.	Xu C, Pan J, Zhou Q, et al. Right vertical infra-axillary thoracotomy for double valve replacement. J Card Surg, 2015, 30(5): 427-430.
8.	Yaliniz H, Topcuoglu MS, Gocen U, et al. Comparison between minimal right vertical infra-axillary thoracotomy and standard median sternotomy for repair of atrial septal defects. Asian J Surg, 2015, 38(4): 199-204.
9.	李慶國, 潘俊, 王強, 等. 右腋下直小切口心內直視手術的解剖學基礎與臨床應用. 中國臨床解剖學雜志, 2012, 29(1): 108-110.
10.	Pan J, Li QG, Zhou Q, et al. Aortopulmonary window with subaortic fibrous stenosis and septal defect: surgery through a minimal right vertical infra-axillary thoracotomy. Heart Surg Forum, 2011, 14(4): E264-E266.

1. Head SJ, ?elik M, Kappetein AP. Kappetein. Mechanical versus bioprosthetic aortic valve replacement. Eur Heart J, 2017, 38(28):2183-2191.
2. 李平, 尤斌, 高峰, 等. 經右胸小切口在二次心臟手術中的應用. 心肺血管病雜志, 2015, 34(6): 465-469.
3. Celiento M, Blasi S, De Martino A, et al. The mosaic mitral valve bioprosthesis: A long-term clinical and hemodynamic follow-up. Tex Heart Inst J, 2016, 43(1): 13-19.
4. Wang H, Liu X, Wang X, et al. Comparison of outcomes of tricuspid annuloplasty with 3D-rigid versus flexible prosthetic ring for functional tricuspid regurgitation secondary to rheumatic mitral valve disease. J Thorac Dis, 2016, 8(11): 3087-3095.
5. Onorati F, Perrotti A, Reichart D, et al. Surgical factors and complications affecting hospital outcome in redo mitral surgery: insights from a multicentre experience. Eur J Cardiothorac Surg, 2016, 49(5): e127-e133.
6. 王瀟, 陶涼, 陳緒發, 等. 右胸微創小切口二尖瓣置換術與傳統二尖瓣置換術的對比分析. 中國胸心血管外科臨床雜志, 2013, 20 (2): 139-143.
7. Xu C, Pan J, Zhou Q, et al. Right vertical infra-axillary thoracotomy for double valve replacement. J Card Surg, 2015, 30(5): 427-430.
8. Yaliniz H, Topcuoglu MS, Gocen U, et al. Comparison between minimal right vertical infra-axillary thoracotomy and standard median sternotomy for repair of atrial septal defects. Asian J Surg, 2015, 38(4): 199-204.
9. 李慶國, 潘俊, 王強, 等. 右腋下直小切口心內直視手術的解剖學基礎與臨床應用. 中國臨床解剖學雜志, 2012, 29(1): 108-110.
10. Pan J, Li QG, Zhou Q, et al. Aortopulmonary window with subaortic fibrous stenosis and septal defect: surgery through a minimal right vertical infra-axillary thoracotomy. Heart Surg Forum, 2011, 14(4): E264-E266.

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右側腋下直切口在二次心臟瓣膜手術中的應用

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