肋间超微创切口封堵干下型室间隔缺损  

Closing doubly committed ventricular septal defect through a super minimal intercostal incision

作　　者：高强[1] 马良龙[1] 张泽伟[1] 金杰[1] Gao Qiang;Ma Lianglong;Zhang Zewei;Jin Jie(Department of Cardiac Surgery&Heart Center,the Childern’s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310052,China)

机构地区：[1]浙江大学医学院附属儿童医院心脏中心心脏外科,国家儿童健康与疾病临床医学研究中心,杭州310052

出　　处：《中华胸心血管外科杂志》2021年第12期725-728,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的总结肋间超微创切口封堵干下型室间隔缺损(DCVSD)的临床应用情况。方法2017年1月至2020年7月,共完成食管超声引导下肋间超微创切口DCVSD封堵术共82例,分析手术操作时间、住院时间、术后并发症等相关数据,术后定期随访评估手术效果。结果82例患儿,术中2例因穿刺点出血,止血导致开关胸时间延长。余患儿总手术时间24~72(47.54±12.06)min,其中放伞时间5~37(16.16±8.01)min,开关胸时间14~59(31.56±9.58)min。术后2例出现心包积液,出院时间超过2周,余患儿术后住院时间3~9(5.79±1.45)天。所有患儿均康复出院,术后随访2~30个月,恢复顺利,无并发症。结论食管超声引导下经肋间超微创封堵DCVSD安全有效,手术创伤小,可在DCVSD选择性应用。Objective Combined with the actual clinical situation,to introduce the application of invasive trans super minimal intercostal device closure in doubly committed ventricular septal defect(DCVSD).Methods Between January 2017 and July 2020,82 DCVSD children were recruited.Relevant data such as operation time,length of hospital stay,postoperative complications,etc.were analyzed,and the follow-up of the postoperative period was used to evaluate the effect of the operation.Results Among them,2 children’s puncture points were bleeding.Chest closure time was obviously extended.The total operation time of the remaining children was 24-72(47.54±12.06)min,among which the umbrella release time was 5-37(16.16±8.01)min,and the chest opening and closing time was 14-59(31.56±9.58)min.Pericardial effusion occurred in 2 patients after operation,and the discharge time was more than 2 weeks.The remaining children were hospitalized for 3-9(5.79±1.45)days after surgery.Conclusion Closing DCVSDs through a super minimal intercostal incision under TEE guidance was safe,effective and less trauma.

关 键 词：室间隔缺损 微创性 心脏外科手术 儿童 

分 类 号：R726.5[医药卫生—儿科]