先天性心脏病介入治疗与外科治疗临床比较  

Comparative study on the congenital heart disease between intervention and surgical procedures

作　　者：梁永梅[1] 韩玲[1] 金梅[1] 郑可[1] 郭保静[1] 张桂珍[1] 肖燕燕[1] 苏俊武[1] 张辉[1] 

机构地区：[1]首都医科大学附属北京安贞医院小儿心脏科,北京100029

出　　处：《心肺血管病杂志》2006年第4期193-195,198,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:对房间隔缺损(ASD)、室间隔缺损(VSD)的介入治疗(Amplatzer封堵器)和外科手术治疗的临床疗效进行比较。方法:2004年5月至12月住院患儿,符合单一左向右分流畸形ASD或VSD,根据治疗方法不同分为介入组和手术组;比较2组在疗效、费用、并发症、输血量及住院时间等方面的异同;通过放免法测定2组治疗前后的心钠素(ANP)水平。结果:2组手术成功率均为100%;介入组均未输血,手术组均输血治疗(P<0·01);术后住院时间介入组少于手术组(P<0·01);治疗费用介入组高于手术组(P<0·01);ANP水平、外科手术及介入治疗后均较治疗前降低。结论:单一ASD、VSD的介入治疗与手术治疗临床效果相同;介入组不需输血,术后住院时间短,但治疗费用较昂贵。Objective：To compare the clinical efficiency of interventional procedure and surgical repair of atrial septal defect （ASD） and ventricle septal defect （VSD）. Method： From May 2004 to December 2004, the patients in our department with ASD or VSD, without associated structural cardiac anomalies, all the patients were divided into two groups： interventional group and surgical group;Results,complications,cost ,hospital stay and transfusion between the two groups were compared; Atrial natriuretic peptide （ANP） were measured before and after treatment by collect venous blood.Result：The technical success rates of both groups were 100%, blood product were administered to all the patients in surgical group, no patients in interventional group required; Hospital stay after operation in surgical greup was7.5 ± 1.2 days versus 5.1 ± 1.3 days in interventional group （P 〈 0.01） ;The mean cost of the interventional procedure was ￥ 45 235 ± 10 204 as compared with ￥ 21 010 ± 1 907 for surgery （ P 〈 0.01 ） ; The patients with ASD or VSD had significantly higher ANP values and it decreased after treatment in both groups. Conclusion ： The efficiency is similar between the interventional procedure and surgical repair for ASD and VSD ; There is the shorter hospital stay, higher cost and no transfusion in the interventional procedure compared with surgical repair.

关 键 词：心脏缺损 先天性 介入治疗 心脏外科手术方法 心钠素 

分 类 号：R540.45[医药卫生—心血管疾病]