| Objective:To study the practical effect of fast track surgery in the clinical application of minimally invasive cardiac surgery, and providing reference and consideration to the clinical cardiac surgery. Methods:76 patients,from 2013.01 to 2014.06, admitted to the department of Cardiac Surgery in Seventh People’s Hospital of Zhengzhou City, were implemented minimally invasive operation. According to the clinical treatment procedures in patients with clinical measures and methods adopted by the different grouping of patients, divided into FTS program group and the traditional program group,38 cases in each group of patients. To observe and compare the clinical effectiveness index, adverse events,and surgical treatment between the two programs.Results:(1) The FTS program: The operation time was (3.88±0.74) h, CPB time was (55.76±11.13) min, Aortic clamping time was (42.13±8.22) min, The traditional program:The operation time was (3.85±0.57) h, CPB time was ((54.55±15.45) min, Aortic clamping time was (40.5±13.01)min. In FTS group,the operation time,CPB time and aortic clamping time, were equal with that of the traditional group, with no difference between groups comparison and data (t=0.198, p=0.8436; t=0.3917, p=0.6964; t=0.6529, p=0.5158);(2) The FTS program:Removal of endotracheal intubation time was(51.13±15.17) min, ICU residence time was(1.09±1.43)h, Assessment of pain after 24h was(4.58±1.96), Postoperative ambulation time was(18.53±5.02)h. The traditional program:Removal of endotracheal intubation time was(595.26±242.11)min,ICU residence time was (22.12±3.19)h,Assessment of pain after 24h was(7.05±1.28), Postoperative ambulation time was(77.34±7.77)h. In FTS group,the time removing endotracheal intubation, ICU residence, assessment of pain after 24h,and postoperative ambulation time were significantly shorter than that of the traditional group, with statistically significant difference between groups comparison and data(t= 13.8271, p=0.0000;t=37.0832, p=0.0000;t=6.5043, p=0.0000;t=38.1899, p=0.0000); (3) The first exhaust time in the FTS program was (15±4.42) h, the first defecate time in the FTS program was (15±4.42) h,the traditional group was (50.82±7.8) h, the traditional group was (50.82±7.8) h. The first exhaust time in FTS group was significantly lower than that of the traditional group, with statistically significant difference between groups comparison and data(t=24.6294, p=0.0000);.The first defecate time in FTS group was significantly lower than that of the traditional group, with statistically significant difference between groups comparison and data(t=3.8862, p=0.0002); (4) The number of days in hospital in the FTS program was (7.13±2.02) d, The number of days in hospital in the traditional group was (11±2.46) d. The number of days in hospital in FTS group was significantly lower than that of the traditional group, with statistically significant difference between groups comparison and data (t=7.4947, p=0.0000); (5) the FTS group,8 patients experienced adverse reactions, the proportion is 21.05%; the traditional group,17 patients experienced adverse reactions, the proportion is 44.74%. The proportion in FTS group was significantly lower than that of the traditional group, with statistically significant difference between groups comparison and data (x2=4.8282, p=0.0280);(6) The drainage after 72h in FTS group was (118.53±44.97) ml, postoperative echocardiography evaluation of surgical results have 1 case occurred residual leakage, the proportion is 2.63%, no one occurred Ⅲ° AV block, the proportion is 0%; The drainage after 72h in traditional group was (187.91±52.63) ml, postoperative echocardiography evaluation of surgical results have 2 cases occurred residual leakage, the proportion is 5.26%, One occurred Ⅲ°AV block, the proportion is 2.63%; The drainage after 72h in FTS group was significantly lower than that of the traditional group, with statistically significant difference between groups comparison and data (t=6.1835, p=0.0000); Postoperative residual leakage was lower than traditional program group, without statistically significant difference between group comparison and data (x2=0.3470, p=0.5558); Ⅲ°AV block incidence was lower than traditional program group, without statistically significant difference between group comparison and data (x2=1.0133, p=0.3141);Conclusion:In the practice of minimally invasive cardiac surgery, compared with the traditional treatment procedures, the FTS program is significant.The operation time,CPB time and aortic clamping time, were equal with that of the traditional group,The time removing endotracheal intubation, living in ICU, assessment of pain after 24h,is lower, Postoperative ambulation time, first exhaust time, first defecate time,were all moved up.The number of days in hospital,and the proportion of adverse reactions,were all declined. Surgery result is better than or equivalent to the traditional program group,is one of the ideal choice in minimally invasive cardiac surgery. |
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