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目的分析胸腔镜下与传统开胸行左心房粘液瘤切除术的临床效果,为临床左心房粘液瘤切除的术式选择提供参考。方法将我院2012年1月至2014年8月69例左心房粘液瘤患者按照手术方式分为两组:胸腔镜组,30例,男8例、女22例,年龄(47.36±13.02)岁;传统开胸组,39例,男10例、女29例,年龄(49.17±13.09)岁。比较两组患者临床效果。结果两组患者术后无死亡,无严重并发症。胸腔镜组与传统开胸组相比,体外循环和主动脉阻断时间较长、但术后住ICU、术后住院和机械通气时间更短、术后胸腔引流管留置时间缩短、胸腔引流量更少且住院总费用更低,术后30 d内恢复工作比例高,两组差异均有统计学意义,P值均<0.05。两组术后早期均未发生脑梗塞等神经系统并发症。术后随访11个月至4年7个月,平均(38.5±12.7)个月,两组粘液瘤均无复发。结论与传统开胸左心房粘液瘤切除术比较,胸腔镜下左心房粘液瘤切除术有效性和安全性更佳,可作为外科治疗左心房粘液瘤优先选择术式。
Objective To analyze the clinical effect of thoracoscopic and conventional thoracotomy for left atrial myxoma resection and provide a reference for the surgical selection of clinical left atrial myxoma resection. Methods Sixty-nine patients with left atrial myxoma from January 2012 to August 2014 in our hospital were divided into two groups according to the operation mode: Thoracoscopic group, 30 cases, 8 males and 22 females, with a mean age of 47.36 ± 13.02 years ; The traditional thoracotomy group, 39 cases, 10 males and 29 females, age (49.17 ± 13.09) years. The clinical effects of two groups were compared. Results There were no postoperative deaths and no serious complications in both groups. Compared with the traditional thoracoscopic group, the thoracoscope group had longer cardiopulmonary bypass and aorta occlusion, but the postoperative ICU stay, postoperative hospital stay and mechanical ventilation were shorter, the postoperative thoracic drainage tube retention time was shortened, thoracic drainage Less and the total cost of hospitalization was lower, and the proportion of patients recovering within 30 days after operation was higher. The differences between the two groups were statistically significant (P <0.05). Neither neurological complications such as cerebral infarction occurred in the early postoperative period in both groups. The patients were followed up for 11 months to 4 years and 7 months, with an average of (38.5 ± 12.7) months. There was no recurrence of myxoma in both groups. Conclusions Compared with the conventional thoracic left atrial myxoma resection, thoracoscopic left atrial myxoma resection is more effective and safe, which can be used as the surgeries for surgical treatment of left atrial myxoma.