山东医药2026，Vol.66Issue(1)：7-11,65,6.DOI:10.3969/j.issn.1002-266X.2026.01.002
不同微创小切口在主动脉瓣置换手术中的应用效果比较
Comparative efficacy of different minimally invasive small incisions in aortic valve replacement
摘要
Abstract
Objective To compare the clinical efficacy of different minimally invasive small incisions in aortic valve replacement.Methods The clinical data from 187 patients with aortic valve disease who underwent aortic valve replace-ment were retrospectively analyzed.And they were divided into the full sternotomy(FS)group(50 cases),the partial up-per sternotomy(PUS)group(50 cases),the right parasternal longitudinal incision(RPLI)group(39 cases),and the right parasternal transverse incision(RPTI)group(48 cases)according to different surgical methods.The types and mod-els of artificial heart valves,types of accompanying surgery,operation time,cardiopulmonary bypass time,aortic occlu-sion time,postoperative blood loss,transfusion volume,ventilator use time,ICU stay time,24 h postoperative drainage,drain retention time,incidence of postoperative complications,postoperative hospital stay time,length of thoracic inci-sion,and degree of thoracic incision pain[visual analogue scale(VAS)score]at discharge were compared between the four groups.Results There were no significant differences between the four groups in terms of artificial valve replace-ment type,valve model,operative time,intraoperative blood transfusion volume,ventilator use time,ICU stay time,or in-cidence of postoperative complications(all P>0.05).Significant differences were observed in the following parameters:type of accompanying surgery,cardiopulmonary bypass time,aortic occlusion time,postoperative blood loss,24 h postop-erative drainage,drain retention time,postoperative hospital stay time,length of thoracic incision,and VAS score at dis-charge(all P<0.05).Further comparisons revealed that the FS group had the highest proportion of concomitant left atrial appendage ligation,the shortest cardiopulmonary bypass and aortic occlusion time,and the highest postoperative blood loss and 24 h postoperative drainage;this group also exhibited the longest drain retention time,postoperative hospital stay time,and thoracic incision length,alongside the highest VAS score at discharge(all P<0.05).The PUS group generally fell between the FS group and the other two groups;the RPLI group and RPTI group demonstrated significantly lower val-ues for the aforementioned indicators compared with the FS and PUS groups(all P<0.05).Furthermore,the RPTI group exhibited a lower VAS score at discharge than the RPLI group(P>0.05).Conclusions Minimally invasive aortic valve replacement is safe and effective,offering advantages such as minimal trauma,mild pain,and rapid recovery.Patients un-dergoing aortic valve replacement through a right parasternal transverse incision will enjoy even more benefits关键词
主动脉瓣置换术/微创手术/胸骨上段小切口/胸骨旁纵行小切口/胸骨旁横行小切口Key words
aortic valve replacement/minimally invasive surgery/partial upper sternotomy/right parasternal lon-gitudinal incision/right parasternal transverse incision分类
医药卫生引用本文复制引用
刘胜中,胡铁,魏大闯,向波,谭今,于涛,黄克力..不同微创小切口在主动脉瓣置换手术中的应用效果比较[J].山东医药,2026,66(1):7-11,65,6.基金项目
四川省自然科学基金(2023NSFSC0588) （2023NSFSC0588）
四川省人民医院临床研究及转化基金(2021LY08). （2021LY08）
