超声引导下胸部微创房间隔缺损封堵术52例临床分析  

Clinical analysis of ultrasound-guided minimally invasive transcatheter closure for atrial septal defect:report of 52 patients

作　　者：方骏 韦洋 陈旭东 王学锋 夏除 FANG Jun1,2, WEI Yang1, CHEN Xudong1, WANG Xuefeng2, XIA Han2(1Department of Cardiac Surgery, Chongqing Kanghua Zhonglian Cardiovascular Hospital, Chongqing, 400045; 2Institute of Cardiovascular Surgery, Second Affiliated Hospital, Army Medical University （Third Military Medical University）, Chongqing, 400037, China)

机构地区：[1]重庆市康华众联心血管病医院心外科,重庆400045 [2]陆军军医大学(第三军医大学)第二附属医院全军心血管外科研究所,重庆400037

出　　处：《第三军医大学学报》2018年第19期1788-1791,共4页Journal of Third Military Medical University

摘　　要：目的探讨超声引导下胸部微创房间隔缺损封堵术的临床应用价值。方法收集2015年3月至2018年1月超声引导下胸部微创行房间隔缺损封堵术的继发孔房间隔缺损(atrial septal defect,ASD)52例患者为封堵组。对照组为同期40例体外循环下行传统房间隔缺损修补术的继发孔房间隔缺损(ASD)患者。采用统计学方法比较两组病例术前ASD大小、输血情况、手术时间、气管插管时间、住院时间,以及不同时相的右心房大小、肺动脉压力、三尖瓣反流情况。结果两组患者手术均获成功。术后无并发症,无残余分流。术后复查心脏彩超右心大小较术前明显减小(P <0.05)。封堵组在手术时间、气管插管时间、住院时间均明显低于对照组(P <0.05)。结论胸部微创超声引导下房间隔缺损封堵术安全、可靠、微创、手术时间短、患者恢复快,优于传统房间隔缺损修补术。ObjectiveTo investigate the clinical value of ultrasoundguided chest minimally invasive closure in treatment of atrial septal defect （ASD）. MethodsA total of 92 patients with ostium secundum ASD （66 cases from Second Affiliated Hospital of Army Medical University and 26 cases from Chongqing Kanghua Zhonglian Cardiovascular Hospital） during March 2015 and January 2018 were retrospectively recruited in this study. Among them, 52 patients （the closure group） underwent ultrasound guided chest minimally invasive closure, while the other 40 patients （the control group） received the repair with extracorporeal circulation. Statistical analyses were used to compare the size of ASD, blood transfusion, operation time, tracheal intubation time, time of hospitalization, including the different stages of the right atrium size, pulmonary artery pressure and tricuspid regurgitation. ResultsThe operations were all successful in the 2 groups of patients. There were no complications and residual shunts after operation. Echocardiography identified the size of right heart was decreased significantly between before and after operations （P〈0.05）. The time of operation, tracheal intubation and length of hospital stay were significantly shorter in the closure group than the control group （P〈0.05）. ConclusionUltrasound guided minimally invasive transcatheter closure is safe, reliable and minimally invasive in treatment of ASD, with shorter operation time and faster recovery time, superior to the traditional repair operation.

关 键 词：房间隔缺损 封堵器 微创手术 

分 类 号：R654.2[医药卫生—外科学] R726.5[医药卫生—临床医学]