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目的分析经右胸前外侧微创小切口行左心房粘液瘤切除术的临床疗效和安全性。方法回顾性分析2011年1月至2013年10月泸州医学院附属医院胸心外科施行经右胸前外侧微创小切口左心房粘液瘤切除术9例患者的临床资料,其中男2例、女7例,年龄37~62(51±9)岁。采用右胸前外侧微创小切口(4~6 cm),经股动、静脉及上腔静脉建立体外循环,经胸阻断升主动脉,灌注冷血心脏停博液,行左心房粘液瘤切除术。结果手术均获成功,无死亡病例。全组总手术时间210~310(260±33)min,升主动脉阻断时间23~50(37±9)min,体外循环时间60~87(71±9)min,术后呼吸机辅助时间6~14(9.0±2.5)h,住ICU时间17~26(20±3)h,术后心包、纵隔引流量100~650(376±190)ml,术后切口长度4.5~6.0(5.3±0.6)cm。术后门诊随访1~30个月,复查心脏彩色超声心动图无复发病例。结论经右胸前外侧微创小切口行左心房粘液瘤切除术安全可行,疗效确切。
Objective To analyze the clinical efficacy and safety of left atrial myxoma resection by minimally invasive right lateral incision. Methods From January 2011 to October 2013, the clinical data of 9 patients with left atrial myxoma resected by minimally invasive right anterior thoracic thoracentesis in Department of Thoracic and Cardiac Surgery, Affiliated Hospital of Luzhou Medical College were retrospectively analyzed. Among them, 2 males and 2 females 7 cases, aged 37 ~ 62 (51 ± 9) years old. A minimally invasive minimally invasive small incision (4 ~ 6 cm) on the right anterior chest was used to establish cardiopulmonary bypass through the femoral artery, vein and superior vena cava. The ascending aorta was transected through the thoracic cavity and perfusion of cold-blooded cardioplegia solution was performed. Left atrial myxoma was excised Surgery. The results of surgery were successful, no deaths. The total operation time was 210-310 (260 ± 33) min, the ascending aorta occlusion time was 23-50 min (37 ± 9) min and the extracorporeal circulation time was 60-87 (71 ± 9) min. The postoperative ventilator-assisted time The duration of ICU was 17 ~ 26 (20 ± 3) h after perioperative period of 6 ~ 14 (9.0 ± 2.5) h and postoperative pericardial and mediastinal drainage of 100 ~ 650 (376 ± 190) ml and postoperative incision length of 4.5 ~ 6.0 0.6) cm. Follow-up postoperative clinic for 1 to 30 months, review of cardiac echocardiography without recurrence. Conclusion The right anterior chest minimally invasive minimally invasive left atrial myxoma resection is safe and feasible, the exact effect.