体表超声心动图引导下经胸微创封堵术治疗房间隔缺损的临床效果分析

摘要
图/表
参考文献(15)
相关文章 (1)

全文: PDF (0 KB) HTML (27 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨体表超声心动图（TTE）引导下经胸微创封堵术与胸腔镜下修补术治疗房间隔缺损（ASD）的临床效果，分析手术优缺点，探讨最佳手术方式。方法选择2011年7月～2017年1月在我院采用微创手术治疗的ASD患者90例，根据手术方式分为将其分为对照组和观察组，每组45例。观察组行体表超声心动图（TTE）引导下经胸微创封堵术，对照组行胸腔镜下修补术，比较两组治疗效果。结果两组患者的手术成功率的比较，差异无统计学意义（P＞0.05）。而观察组患者的手术时间、术后ICU入住时间、使用呼吸机时间、术后住院时间均显著短于对照组，差异有统计学意义（P＜0.05）；观察组患者的手术切口显著小于对照组，差异有统计学意义（P＜0.05），观察组患者的住院总费用低于对照组，差异有统计学意义（P＜0.05），术中出血量、术后胸腔引流量、总输血量少于对照组，差异有统计学意义（P＜0.05）。两组患者的术后并发症发生率的比较，差异无统计学意义（P＞0.05）。结论两种手术方式均是治疗ASD安全有效的方法，但体表超声心动图（TTE）引导下经胸微创ASD封堵术无需体外循环，对患者创伤小，操作简便，临床效果显著，可在基层单位加以推广应用。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	曹西迎
	李章红
	李树林
	罗志方
	熊健宪

关键词 ：外科封堵术, 胸腔镜, 先天性房间隔缺损, 超声心动图引导

Abstract：ObjectiveTo investigate the difference of clinical effect of transthoracic minimally-invasive closure and thoracoscopic repair in the treatment of atrial septal defect(ASD)under the guidance of transthoracic echocardiography(TTE)so as to analyze the advantages and disadvantages of two surgeries and discuss the best choice.MethodsNinety patients with ASD who underwent minimally invasive surgery in our hospital from July 2011 to January 2017 were selected and divided into control group and observation group according to the operation mode,with 45 cases in each group.The observation group was treated with transthoracic minimally invasive occlusion guided by body surface TTE,and the control group was treated with video-assisted thoracoscopic repair.The therapeutic effects of the two groups were compared.Altogether There was no significant difference between the two groups(P＞0.05).The operation time,ICU stay time,ventilator use time and hospital stay were significantly shorter in the observation group than those in the control group(P＜0.05).The size of surgical incision in the observation group was significantly smaller than that in the control group (P＜0.05).The total cost of hospitalization in the observation group was lower than that in the control group(P＜0.05).The amount of intraoperative bleeding,postoperative thoracic drainage and total blood transfusion in the observation group were lower than that in the control group (P＜0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P＞0.05).ResultsThere was no significant difference between the two groups(P＞0.05).The operation time,ICU stay time,ventilator use time and hospital stay were significantly shorter in the observation group than those in the control group(P＜0.05).The size of surgical incision in the observation group was significantly smaller than that in the control group (P＜0.05).The total cost of hospitalization in the observation group was lower than that in the control group(P＜0.05).The amount of intraoperative bleeding,postoperative thoracic drainage and total blood transfusion in the observation group were lower than that in the control group (P＜0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P＞0.05).ConclusionBoth the two surgeries are safe and effective methods for the treatment of ASD.But the TTE-guided minimally-invasive ASD closure has the features of less trauma,simple operation and significant clinical effect without extracorporeal circulation,which can be applied in the grass-roots units.

Key words： Surgicalclosure Thoracoscopy Congenital atrial septal defect Echocardiographic guidance

基金资助:江西省赣州市科技局科技计划项目（GZ2016ZSF 028）

引用本文:

曹西迎 ;李章红 ;李树林; 罗志方; 熊健宪. 体表超声心动图引导下经胸微创封堵术治疗房间隔缺损的临床效果分析[J]. 中国当代医药, 2018, 25(4): 47-49转53.
CAO Xi-ying LI; Zhang-hong ;LI Shu-lin; LUO Zhi-fang; XIONG Jian-xian. Clinical effect of transthoracic minimally invasive transcatheter closure of atrial septal defect guided by body surface echocardiography. 中国当代医药, 2018, 25(4): 47-49转53.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2018/V25/I4/47

[1]	Zhu P，Sun Y，Yang Q，et al.Intraoperative device closure of atrial septal defects with minimal transthoracic invasion：a single-center experience[J].Texas Heart Institute Journal，2013，40（3）：256-260.
[2]	李才，田作春，朱勇德，等.127例经胸微创房间隔缺损封堵术的临床应用研究[J].重庆医学，2015，44（30）：4267-4269.
[3]	Chitwood WR，Rodriguez E，Chu MW，et al.Robotic mitral valve repairs in 300 patients：A single-center experience[J].J Thorac Cardiovasc Sury，2008， 136（2）：436-441.
[4]	宋振江，李晓峰，柏松，等.先心病房间隔缺损介入治疗前后心功能对照研究[J].中国医药导报，2015，12（29）：55-58.
[5]	王春凤，曹剑锋，辛鸿飞.实时三维超声心动图在房间隔缺损介入封堵术中的应用[J].中国中西医结合影像学杂志，2013，11（1）：153-155.
[6]	朱晓东，张宝仁.心脏外科学[M].北京：人民卫生出版社，2007：398-410.
[7]	崔政，宋兵.非体外循环经胸微创封堵术治疗房间隔缺损的临床应用[J].中国当代医药，2013，20（33）：17-19.
[8]	唐红，张尔永，解俊敏，等.食管超声心动图监测下经胸微创房间隔缺损封堵术[J].中国胸心血管外科临床杂志，2006，（5）：349-351.
[9]	全丽娟，金惠红，朱文军.三维食管超声心动图在经胸小切口房间隔缺损封堵术中的应用[J].心脑血管病防治，2014，14（3）：204-206.
[10]	李春平，韩涛.经胸超声心动图引导下经皮房间隔缺损封堵术 35 例临床分析[J].中外医学研究，2017，26（10）：20-21.
[11]	Teo KS，Disney PJ，Dundon BK，et al.Assessment of atrial septaldefects in adults comparing cardiovascular magnetic resonance with transoesophageal echocardiography[J].J Cardiovasc Magn Reson，2010，12（1）：44.
[12]	张泽伟.先天性心脏病的外科治疗进展[J].中国医师杂志，2014，16（9）：1009-1011.
[13]	孙晓宁，赵强，陈安清，等.右胸小切口封堵缺乏边缘的Ⅱ孔型房间隔缺损[J].中华胸心血管外科杂志，2009，25（2）：93－95.
[14]	Walther T，Binner C，Rastan A，et al.Surgical atrial septal defect closure after interventional occluder placement：incidence and outcome[J].J Thorac Cardiovasc Surg，2007，134（3）：731-737.
[15]	邢泉生.先天性心脏病经胸微创封堵术[M].北京：人民卫生出版社，2014：169-174.