TEE下经胸微创封堵技术在低龄低体重患儿室间隔缺损中的应用研究  

Application of Minimally Invasive Transthoracic Occlusion under TEE in Ventricular Septal Defect of Children with Low Age and Low Weight

作　　者：章祖雄[1] 杨升平 余俊键[1] 古亮 胡硕 唐志贤[1] ZHANG Zuxiong;YANG Shengping;YU Junjian;GU Liang;HU Shuo;TANG Zhixian(The First Affiliated Hospital of Gannan Medical College,Ganzhou 341000,China)

机构地区：[1]赣南医学院第一附属医院,江西赣州341000 [2]江西省赣州市上犹县中医院

出　　处：《中国医学创新》2020年第30期29-33,共5页Medical Innovation of China

基　　金：赣州市指导性科技计划项目(GZ2017ZSF022)。

摘　　要：目的:探讨TEE下经胸微创封堵技术在低龄低体重患儿室间隔缺损(VSD)中的应用。方法:选取2016年4月-2018年10月本院收治的低龄低体重VSD患儿64例为研究对象。应用信封法将其分为对照组与研究组,每组32例。对照组采用传统体外循环VSD手术治疗,研究组采用TEE引导下经胸微创封堵技术进行治疗。观察两组临床指标、不良事件发生情况,比较两组患儿术后1年生活质量情况。结果:研究组手术耗时、呼吸机辅助时间、监护室(ICU)滞留时间、术后住院时间均短于对照组,输血量、住院费用均少于对照组,差异均有统计学意义(P<0.05)。研究组残余返流、新发返流、心功能不全、心律失常、Ⅰ度房室传导阻滞的总发生率低于对照组,差异有统计学意义(P<0.05)。研究组患儿术后1年的生活质量各项评分均高于对照组,差异均有统计学意义(P<0.05)。结论:将TEE下经胸微创封堵技术应用在低龄低体重患儿VSD的临床治疗中,可有效改善患儿临床治疗指标水平,减少患儿不良事件的发生率,还能提高患儿术后生活质量,应用效果满意,可考虑进一步推广。Objective:To explore the application of minimally invasive transthoracic occlusion under TEE in ventricular septal defect(VSD)of children with low age and low weight.Method:Sixty-four children with low age and low weight VSD admitted to our hospital from April 2016 to October 2018 were selected as study subjects.They were divided into control group and study group by envelope method,32 cases in each group.The children in the control group were treated with traditional extracorporeal circulation VSD surgery,while the children in the study group were treated with TEE guided minimally invasive thoracic occlusion.The clinical indicators and adverse events of children in the two groups were observed,and the quality of life of children in the two groups one year after surgery was compared.Result:The operation time,ventilator assisted time,ICU stay time and postoperative hospital stay in the study group were shorter than those in the control group,the blood transfusion volume and hospitalization expenses were less than those in the control group,the differences were statistically significant(P<0.05).The total incidence of residual reflux,new reflux,cardiac insufficiency,arrhythmia andⅠdegree atrioventricular block in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).The quality of life scores of the study group were higher than those of the control group one year after operation,the differences were statistically significant(P<0.05).Conclusion:The application of minimally invasive transthoracic occlusion under TEE to the clinical treatment of VSD in children with low age and low weight can effectively improve the level of clinical treatment indicators,reduce the incidence of adverse events in children,but also improve the postoperative quality of life of children.The application effect is satisfactory,and further promotion can be considered.

关 键 词：TEE下 经胸微创封堵技术 低龄低体重患儿 室间隔缺损 

分 类 号：R726.5[医药卫生—儿科]