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全胸腔镜下主动脉瓣联合二尖瓣置换手术患者生活质量与手术切口疼痛的研究。

A Study for QOL and Surgical Incision Pain in Patients Undergoing Totally Thoracoscopic Combined Aortic and Mitral Valve Replacement Surgery.

机构信息

Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, 350001 Fuzhou, Fujian, China.

出版信息

Heart Surg Forum. 2023 May 28;26(3):E219-E224. doi: 10.1532/hsf.5411.

Abstract

BACKGROUND

In recent years, based on traditional median sternotomy surgery, totally thoracoscopic for aortic and mitral valve replacement surgery is increasingly being performed despite little published evidence. This study investigated postoperative pain and short-term quality of life (QOL) of patients undergoing double valve replacement surgery.

METHODS

From November 2021 to December 2022, 141 patients with double valvular heart disease who underwent thoracoscopic group (N = 62) and median sternotomy group (N = 79) were included. Clinical data were recorded, and a visual analog scale (VAS) was used to measure postoperative pain intensity. The medical outcomes study (MOS) 36-item Short-Form Health Survey assessed short-term QOL after surgery.

RESULTS

Sixty-two patients underwent total thoracic double valve replacement, and 79 patients underwent median sternotomy double valve replacement. Both groups were similar in terms of demographics and general clinical data, as well as the incidence of postoperative adverse events. The VAS scores of the thoracoscopic group were lower than those in the median sternotomy group. The hospital stay time was significantly shorter in the thoracoscopic group than in the median sternotomy group (30.2 ± 12 days vs. 36 ± 19 days, p = 0.03). The scores of bodily pains and some of the subscales in SF-36 were significantly different between the two groups (p < 0.05).

CONCLUSIONS

Thoracoscopic combined aortic and mitral valve replacement surgery can reduce postoperative pain and improve short-term postoperative QOL, which has specific clinical application value.

摘要

背景

近年来,尽管发表的证据很少,但基于传统的正中胸骨切开术,全胸腔镜主动脉瓣和二尖瓣置换术越来越多地被应用。本研究旨在探讨双瓣置换术后患者的术后疼痛和短期生活质量(QOL)。

方法

2021 年 11 月至 2022 年 12 月,纳入 141 例接受胸腔镜组(n=62)和正中胸骨切开组(n=79)的双瓣心脏病患者。记录临床数据,并使用视觉模拟评分(VAS)测量术后疼痛强度。采用医疗结局研究 36 项简短健康调查(MOS SF-36)评估术后短期 QOL。

结果

62 例患者接受了全胸腔镜双瓣置换术,79 例患者接受了正中胸骨切开双瓣置换术。两组患者在人口统计学和一般临床数据以及术后不良事件发生率方面无差异。胸腔镜组的 VAS 评分低于正中胸骨切开组。胸腔镜组的住院时间明显短于正中胸骨切开组(30.2±12 天 vs. 36±19 天,p=0.03)。SF-36 的躯体疼痛和部分子量表评分在两组之间存在显著差异(p<0.05)。

结论

胸腔镜联合主动脉瓣和二尖瓣置换术可减轻术后疼痛,改善短期术后 QOL,具有特定的临床应用价值。

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