目的探索食管癌、贲门癌、贲门失弛缓症术后胸腔感染的有效处理方法。 方法选取我院胸外科2012年1月至2014年6月间因食管癌、贲门癌、贲门失弛缓症手术并发食管胸腔瘘的患者42例,分为常规+臭氧治疗组和常规治疗组。常规治疗组28例,男22例、女6例,年龄54~78(63.5±6.8)岁,行胸腔闭式引流、抗感染、营养支持治疗;常规+臭氧治疗组14例,男11例、女3例,年龄39~74(64.7±9.1)岁,行常规治疗+臭氧胸腔保留灌注治疗。 结果两组年龄、性别、体重差异均无统计学意义(P>0.05),常规+臭氧治疗组疗效明显优于常规治疗组:住院时间更短(P=0.017),住院费用更低(P=0.016),死亡率[0.00%(0/14)vs. 10.71%(3/28)]更低。 结论臭氧具有便捷、杀菌、消毒、不良反应以及促进脓腔吸收的作用,可以提高治疗效果,缩短住院时间,减少住院费用,值得临床推广和运用。
Objective To investigate the clinical efficacy of mitral valve repair technique in the treatment of rheumatic mitral valve lesions. Methods The clinical data of patients diagnosed with rheumatic mitral valve lesions and undergoing mitral valve repair under extracorporeal circulation in our department from 2021 to 2022 were retrospectively analyzed. Results A total of 100 patients were collected, including 78 females and 22 males with an average age of 52 years. There were no secondary open heart or death in the whole group. Extracorporeal circulation time was 136.3±33.1 min, aortic cross-clamping time was 107.6±27.5 min, ventilator use time was 12.9±5.9 h, ICU stay was 2.6±1.4 d, and vasoactive medication use was 823.4±584.4 mg. Before and after the surgery, there were statistical differences in the left ventricular end diastolic diameter, left atrial end systolic diameter, effective mitral valve orifice area, shortening rate of left ventricular short axis, mitral E-peak blood flow velocity, mean mitral transvalvular pressure difference, mitral pressure half-time, and cardiac function graded by New York Heart Association (P<0.05). While there was no statistical difference in left ventricular ejection fraction or left ventricular end-diastolic volume (P>0.05). Conclusion Overall repair of rheumatic mitral valve lesions can significantly improve the cardiac function and hemodynamics of the patients, and is a good choice for patients with rheumatic mitral valve lesions.