超声引导下经皮/经胸房间隔缺损封堵的临床研究  

Ultrasound-guided percutaneous/transthoracic closure of atrial septal defect

作　　者：唐先成[1] 刘健[1] 黄击修 林小彬[1] Tang Xiancheng;Liu Jian;Huang Jixiu;Lin Xiaobin(Department of Cardiovascular Surgery,Jianyang People's Hospital,Jianyang,Sichuan 641400,China)

机构地区：[1]简阳市人民医院心血管外科,四川简阳641400

出　　处：《现代临床医学》2020年第2期102-105,共4页Journal of Modern Clinical Medicine

摘　　要：目的:总结单纯通过超声引导下经皮/经胸房间隔缺损(ASD)封堵的临床效果。方法:回顾性分析2012年2月至2017年10月收治的ASD患者的临床资料,按采用手术方式分为经胸封堵组(29例)及经皮封堵组(22例),对比两组治疗的成功率、手术相关指标及并发症发生率。结果:经胸封堵组27例封堵成功,经皮封堵组20例封堵成功,两组封堵成功率、手术时间、术中出血量差异均无统计学意义(P>0.05);经胸封堵组并发症发生率高于经皮封堵组(P<0.05),ICU住院时间、呼吸机辅助时间、术后住院时间均长于经皮封堵组(P<0.01)。全部病例均无残余分流、房室传导阻滞、心脏磨蚀等。结论:单纯超声引导下经皮ASD封堵术式是一种安全、有效的手术方式。但对于直径较大、缺损边缘薄弱的ASD,经胸封堵可能更有其优势。Objective:To summarize the clinical efficacy of percutaneous/transthoracic closure of atrial septal defect(ASD)guided by ultrasound alone.Methods:A retrospective analysis of patients with ASD admitted from February 2012 to October 2017 was performed.According to the choice of surgical approach,the patients were divided into transthoracic closure group(29 cases)and percutaneous closure group(22 cases).The success rate,operation related indexes and complication rate were compared between the two groups.Results:In the transthoracic closure group,27 cases were successfully blocked,and 20 cases in the percutaneous closure group were successfully blocked.There were no significant differences in the success rate of closure,operation time and intraoperative hemorrhage between the two groups(P>0.05);the complication rate of the transthoracic group was higher than that of the percutaneous group(P<0.05),and the length of stay in ICU,ventilator support time,postoperative hospital stay were longer than that of the percutaneous group(P<0.01).All patients had no residual shunt,atrioventricular block and heart abrasion,etc..Conclusion:Simple ultrasound-guided percutaneous closure of ASD is a safe and effective surgical procedure.However,for ASD with large diameters and weak margins,transthoracic closure may have more advantages.

关 键 词：超声引导 经皮封堵 经胸封堵 房间隔缺损 

分 类 号：R654[医药卫生—外科学]