小儿先天性房间隔或室间隔缺损在超声心动图引导下经食管或经胸介入封堵与外科经胸小切口封堵疗效差异  

Difference of curative effects by ultrasonic cardiogram-guided transesophageal or transthoracic interventional occlusion and transthoracic mini-incision occlusion in the treatment of pediatric congenital atrial septal defect or ventricular septal defect

作　　者：张阳春[1] 肖纯[1] 钟卫权[1] 廖火城[1] ZHANG Yang-chun;XIAO Chun;ZHONG Wei-quan(Department of Cardiothoracic Surgery, Guangzhou Huizhou City Third People’s Hospital, Huizhou 516000, China)

机构地区：[1]广东省惠州市第三人民医院心胸外科,516000

出　　处：《中国现代药物应用》2017年第11期48-50,共3页Chinese Journal of Modern Drug Application

基　　金：惠州市科技计划项目(项目编号:20160805)

摘　　要：目的探讨小儿先天性房间隔、室间隔缺损在超声心动图引导下经食管或经胸介入封堵与外科经胸小切口封堵临床疗效差异。方法 50例小儿先天性房间隔、室间隔缺损患儿,根据患儿治疗方法不同分为A组(24例)和B组(26例)。A组患儿采用超声心动图引导下经食管或经胸介入封堵术治疗,B组患儿采用经胸小切口封堵术治疗。比较两组患儿一次性封堵成功率、手术时间、住院时间、封堵缺损口大小;对两组患儿随访6个月,比较术后残余分流、封堵器移位、瓣膜关闭不全、传导阻滞并发症发生情况。结果两组患儿一次性封堵成功率比较差异无统计学意义(χ~2=1.1054,P>0.05)。A组患儿手术时间长于B组,封堵缺损口小于B组,差异具有统计学意义(P<0.05);两组患儿住院时间比较差异无统计学意义(P>0.05)。A组患儿传导阻滞发生率为16.67%,高于B组的0,差异具有统计学意义(P<0.05);两组患儿残余分流、封堵器移位、瓣膜关闭不全发生率比较差异无统计学意义(P>0.05)。结论超声引导下介入封堵术和外科经胸封堵术在小儿先天性房间隔或室间隔缺损中治疗均能获得显著临床疗效,但外科经胸小切口封堵术能提高封堵效果和封堵质量,对于缺损面积较大患儿较为适宜,临床中应根据患儿缺损形态、面积等综合情况选择手术方式。Objective To investigate curative effects by ultrasonic cardiogram-guided transesophagealor transthoracic interventional occlusion and transthoracic mini-incision occlusion in the treatment of pediatriccongenital atrial septal defect or ventricular septal defect.Methods A total of50children patients with pediatriccongenital atrial septal defect or ventricular septal defect were divided by different treatment measures intogroup A(24cases)and group B(26cases).Group A received ultrasonic cardiogram-guided transesophageal ortransthoracic interventional occlusion for treatment,and group B received transthoracic mini-incision occlusionfor treatment.Comparison was made on success rate of one-time occlusion,operation time,hospital stay time,andenclosed defect area size between the two groups.After6-month follow-up for the two groups,their postoperativeresidual diffluence,plugging device displacement,valvular inadequacy and occurrence of conduction blockcomplications were compared.Results There was no statistically significant difference of success rate of onetimeocclusion between the two groups(χ2=1.1054,P>0.05).Group A had longer operation time and smallerenclosed defect area than group B,and their difference had statistical significance(P<0.05).The difference ofhospital stay time between the two groups had no statistical significance(P>0.05).Group A had higher incidenceof conduction block as16.67%than0in the control group,and the difference had statistical significance(P<0.05).There was no statistically significant difference of incidence of residual diffluence,plugging device displacement,and valvular inadequacy between the two groups(P>0.05).Conclusion Implement of ultrasonic cardiogramguidedtransesophageal or transthoracic interventional occlusion shows excellent curative effect in treatingpediatric congenital atrial septal defect or ventricular septal defect,while transthoracic mini-incision occlusionis suitable for large defect area with improved occlusion effect and quality.Clinical selection of surgical measure

关 键 词：小儿 房间隔缺损 室间隔缺损 经胸小切口封堵术 超声心动图 介入封堵术 

分 类 号：R726.5[医药卫生—儿科]