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加拿大28开奖官网
【心外科】郭惠明团队完成国内首例微创全腔镜下肥厚性心肌病治疗
作者: 唐亚捷   审核: 宣传科    点击数: 21283    发布时间: 2019-06-21    字号: 放大 缩小

加拿大28开奖官网        feihouxingxinjibing(hcm)shizuichangjiandeyichuanxingxinzangbing,biaoxianweixinshibi(changjianyushijiange)zenghou,shidaozhinianqingyundongyuancusideshouyaobingyin。yue70%dehcmhuanzhehebingyouzuoshiliuchudaogengzuheerjianbanfanliu,zheileihuanzhedelinchuangzhengzhuanggengzhong、siwanglvgenggao,chengzhiweifeihougengzuxingxinjibing(hocm)。

加拿大28开奖官网        2011nianmeiguoxinzangbingxuehui(aha)he2014nianouzhouxinzangbingxuehui(esc)guanyuhcmdezhinanzhongdouyiduihocmdezhiliaoliuchengzuochulemingquedeshuoming——duiyuneikeyaowuzhiliaoxiarengyouhenmingxianzhengzhuangdehuanzheshouxuanwaikeshoushuzhiliao,jixinjiqiechushu。duihocmdexinjiqiechushuyaoqiuzaibusunshangzhouweizhongyaojiegou(zhudongmaiban、erjianban、xishishudeng)deqiantixiazugouduodeqiechufeihoushijiange,ruoqiechufanweiguoxiao,zehuiyoucanyugengzu,xuyaoercishoushu。ruoqiechuguoduozehuidaozhiyiyuanxingshijiangechuankonghexuyaozhiruqiboqidewanquanfangshichuandaozuzhi。chucizhiwai,qiechuxiaoguobumanyidehuanzhehaihuizaochengweishuqitingjikunnan、fanfushizhanbingzenggaoweishuqibingfazhengfashenglvhesiwanglv,suoyishuzhongduiqiechufanweiyidingyaobakongdefeichangjingque,ershijiangejirouqiechuguoshaoheqiechuguoduoderongcuoqujianwangwangzhiyou1cmzuoyou。jianyuxinjiqiechushuduijingzhunxingdegaoyaoqiuheqiechushibaisuodaozhideweishuqigaofengxian,zhinanmingquetuijianhuanzhezaiyoujingyandedaxingxinzangzhongxinwanchenggaishoushu。

加拿大28开奖官网        chuantongdezhengzhongkaixiongjingzhudongmaixinjiqiechushushimuqianyingyongzuiduodeshushi(tu1),yinweizhudongmaibanhuanzhijingzhiyou2cmzuoyou,suoyizheiyiruluduizhudongmaibanxiajiegoudexianlufeichangyouxian,duishuzheyeshiyigehendadetiaozhan,jishiyizhuyenanyikandaozhudaodeshenbucaozuo,zengjialepeixunqitawaikeyishengdenandu,yeshidaozhigaishushimuqianjinzaiquanqiujigedaxingxinzangzhongxinkaizhandezhongyaoyuanyin。


图1.传统经主动脉入路心肌切除术: 术中显露受限明显。

        weilegaishanshuzhongxianlu、jianshaohuanzheshuhoubingfazhengfashenglv,guohuimingtuanduizonghelexinwaike3ddayinheqiangjingxinwaikeshoushuliangdahexinjishu,chenggongwanchengleguoneidiyili3ddayinfuzhuquanqiangjingxiajingzuofangerjianbanruluxinjiqiechushu。

        gaijishuyouliangdatedian: yishiduiqiechufanweideshuqianpinggu。jianada28kaijiangguanwangyuan3ddayinyingyongyuzhiliaofuzaxingxinzangbingdejishuyidedaoguangfanyingyong。zuixintongji,3ddayinjiejin500li,vrhemrjiejin100li。yituoshengyixinwaikeshouxizhuanjiazhuangjianzhuren、huangmeipingzhurendailingde3ddayinshiyanshituanduizaishuqianjianmohedayinhocmhuanzhexinzangmoxing,shoushutuanduitongguoduimoxingdepingguhemonishoushucaozuoyuyanshoushu,jinyibumingqueshuzhongdeqiechufanwei(tu2),zheiyeshiguozhurentuanduiweizheixiexinjishujigaonandushoushusuozuochudechongfendeshuqianzhunbei。


图2. 术前3D打印模型上模拟切除肥厚室间隔。

        ershiduiqiechufanweideshuzhongpinggu: xiangbiyuchuantongdezhengzhongkaixiongjingzhudongmairuluxinjiqiechushueryan,quanqiangjingxiazuofangerjianbanruludeshiyegengweiqingxi(tu3),bujinliyushuzheshuzhongduijiepoujiegoudepanduan,erqieliyujiaoxueheshushituiguang。jianada28kaijiangguanwangyuanxinwaikeyiwanchenglechaoguo5000yuliqiangjingxinwaikeshoushu,chengshuxinideqiangjingshoushujishuweihocmhuanzheshoushudeliuchangxingheanquanxingtigonglejudadebaozhang。


图3. 腔镜下术野清晰,解剖结构明确。

        xiongqiangjingsuodailaideweichuangxiaoguobujinshiqiekoudemeiguan,haiyoushuzhongshuxueliang、shuhouqiekoubingfazhengfashenglvdexiajiang,zheiyexiaochulehenduohuanzheduizhengzhongkaixiongdekongju。erqie,shoushudeanquanxingdadatigao。muqiangaituanduiyiwancheng3lishoushu,shuhouhuanzhezuoshiliuchudaogengzuwanquanjiechu、erjianbanfanliuxiaoshi,wushijiangechuankongjiwanquanfangshichuandaozuzhidefasheng(tu4)。


图4. A.术前经食管超声下可见左室流出道高速血流(黑色箭头所指处)及二尖瓣中量反流(白色箭头所指处)
加拿大28开奖官网 B. 术后经食管超声可见左室流出道通畅,无二尖瓣反流。

        在医院“提升疑难重病诊治水平、创新医疗技术” 的学科发展核心理念指导下,郭惠明团队利用心外科的优势技术积极开展腔镜下HOCM的精准微创治疗方法,并获得了阜外医院王水云教授的高度认可,他认为“这是HOCM治疗新的突破,并能更好地培训外科医生掌握扩大心肌切除术”。该技术将更多更好地解决患者的病痛,同时也帮助心研所建立起华南地区的心肌病中心,让HCM患者得到更系统、更完善的临床诊治。

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