外科微创封堵术治疗继发孔房间隔缺损的临床应用  

The clinical application of mini-invasive surgery to close secundum atrial septal defect with special occluder device

作　　者：刘胜中[1] 丛伟[1] 曾富春[1] 甘崇志[1] 耕噶[1] 

机构地区：[1]四川省人民医院心胸外科,四川成都610072

出　　处：《四川医学》2010年第2期173-175,共3页Sichuan Medical Journal

摘　　要：目的总结外科微创封堵术治疗继发孔房间隔缺损（ASD）的临床应用经验，评价其安全性和疗效。方法全组9例，ASD直径14～31mm。均在全麻下经右胸第4肋间隙胸骨旁2—3cm小切口进胸，再经食管心脏彩超（TEE）引导下经输送器置入封堵器。结果9例手术均成功，1例术后3h封堵器脱落，换用大号封堵器后再次封堵成功。全组术后无并发症发生，术后2～6d出院；经1～10个月随访，无残余分流发生，右房、室缩小，肺动脉压明显降低，心功能改善。结论外科微创封堵术治疗ASD创伤小、术后恢复快，且安全、有效，值得临床推广应用。Objective To summarize the experience of mini-invasive surgery to close secundum atrial septal defect （ASD） with special occluder device and to evaluate its safety and efficacy. Methods 9 cases of patient with ASD were treated by mini-invasive surgery. The diameter of ASD was 14 to 31mm. All patients were anaesthetized generally and a 2 to 3cm long incision was made in the fourth intereostals space of right side of sternum. ASD was closed with special occluder device under transesophageal echocardiography（TEE） guidance. Results All patients were successfully occluded. The occluder exfoliated after 3 hours in 1 case, but ASD was successfully closed again with large occluder. No complications happened. All patients were discharged from the hospital 2 to 6 days after the surgery. No residual shunt was found, heart size and function were improved during 1 to 10 months following-up. Conclusion Mini-invasive surgery to close ASD with special occluder device is mini-invasive,safe and efficient. It could be widely used in clinical.

关 键 词：房间隔缺损 继发孔 微创外科 封堵器 

分 类 号：R541.1[医药卫生—心血管疾病]