胸腔镜心脏外科手术现状及展望_顾剑民

血浆BNP(126?53)c m/s比(85?45)c m/s,P< 0.05)。持续变量的多元回归分析B NP为血栓形成的显著预测因子。血浆B NP水平和左心耳血流速度呈显著负相关(r=0.38,P<0.05)。但是此项研究入选病例数少,同时对于血栓组,BNP的测定在血栓形成后,故B NP对血栓形成的预测价值需要进一步的前瞻性研究证实。

5B NP的应用前景

综上所述,房颤患者监测血BNP浓度在临床评价、指导治疗和评估预后等方面有重要价值。已有多个研究表明BNP在房颤时发生改变,更能反映房颤时血流动力学变化、复律后稳定性及血栓栓塞等并发症,揭示潜在器质性心脏病及心功能不全。在一定的临床背景下作为一项生化指标,B NP测定具有价廉、检测方便、可靠、重复性强等优点,相信随着相关研究的进一步深入,BNP在包括房颤在内的心血管疾病中应用将更为广泛。

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收稿日期:2008-07-30修回日期:2008-11-19

胸腔镜心脏外科手术现状及展望

顾剑民综述郑家豪审校

(上海交通大学医学院附属仁济医院胸心外科,上海200001)

D evelop m ent and

E xpectation of Endoscopic Cardiac Surgery

GU Jian-m i n,Z H E NG Jia-hao

(D epart men t of T horacic and Card iovascular Surgery,RenjiH osp it al of M e d ical Schoo l,Shanghai J iaotong University,Shanghai200001, China)

文章编号:1004-3934(2009)03-0419-04中图分类号:R654.2文献标识码:A

摘要:胸腔镜应用于心脏外科已有十多年,相对于传统心脏外科手术具有减少外科创伤、减缓疼痛、失血少、恢复快、美容效果好等优点。国外胸腔镜心脏外科多以机器人辅助完成多种心脏手术,国内一般单用胸腔镜辅助完成房间隔缺损修补术、室间隔缺损修补术、二尖瓣置换术,以及心房颤动射频消融术,现将胸腔镜辅助心脏外科手术的现状及进展进行综述。

关键词:胸腔镜;机器人辅助;心脏外科

Abstrac t:Endoscopic techn i ques have now been a part o f cardiac surg ery f o rm ore a decade.Endoscopic cardiac surgery has advanta-ges ov er trad iti onal i nvasi ve surgery i n t hat it causes l ess surg ica l trau m a,has a f aster recove ry ti m e,better cos m etic outco m es,and reduces pa i n and bleed i ng.It has been successf u lly comp l e ted abroad w ith t he assistance o f a robo ti c syste m.R ecently i n Ch i na a series of endoscop-ic card i ac surger i es have been perfor m ed to repa ir an atria l septa l de fect,and ven tricu lar septal de fect.Endo scop i c cardiac surgery has also been used i n m itral va l ve replace m ent and a tria l fi br illation rad i ofrequency ablation,genera lly i n t he absence of robo ti c enhance m ent.T his rev ie w w ill su mm ar ize the deve l op m ent o f endoscopic card i ac surgery.