[1]赵 阳,殷传军,冯立锋,等.经胸小切口封堵治疗房间隔缺损疗效及对患者心功能影响的临床研究[J].陕西医学杂志,2021,50(1):75-78.[doi:DOI:10.3969/j.issn.1000-7377.2021.01.020]
 ZHAO Yang,YIN Chuanjun,FENG Lifeng,et al.Efficacy of transthoracic small incision closure in treatment of atrial septal defect and its effect on cardiac function[J].,2021,50(1):75-78.[doi:DOI:10.3969/j.issn.1000-7377.2021.01.020]
点击复制

经胸小切口封堵治疗房间隔缺损疗效及对患者心功能影响的临床研究
分享到:

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年1期
页码:
75-78
栏目:
临床研究
出版日期:
2021-01-05

文章信息/Info

Title:
Efficacy of transthoracic small incision closure in treatment of atrial septal defect and its effect on cardiac function
作者:
赵 阳殷传军冯立锋高继东冯 喆郑明非潘黎明
(北京市第六医院心血管外科,北京100007)
Author(s):
ZHAO YangYIN ChuanjunFENG LifengGAO JidongFENG ZheZHENG MingfeiPAN Liming
(Department of Thoracic and Cardiovascular Surgery,Beijing Sixth Hospital,Beijing 100007,China)
关键词:
胸骨正中开胸 经胸小切口封堵 房间隔缺损 心功能 并发症 生活质量
Keywords:
Mid-sternal thoracotomy Transthoracic small incision closure Atrial septal defect Cardiac function Complication Quality of life
分类号:
R 541.1
DOI:
DOI:10.3969/j.issn.1000-7377.2021.01.020
文献标志码:
A
摘要:
目的:分析经胸小切口封堵治疗房间隔缺损(ASD)的疗效及对心功能的影响。方法:选择180例ASD患者,随机分组(每组样本容量90例),对照组给予胸骨正中开胸房间隔缺个损修补术治疗,试验组给予经胸小切口ASD封堵术治疗,对比两组手术指标、心功能指标、并发症发生率,随访2月,对比两组SF-36评分。结果:试验组手术时间、呼吸机停用时间、重症监护时间及切口长度均显著比对照组短,试验组术后引流量明显比对照组少,试验组术后3 d 左室舒张末期内经(LVEDD)、左房前后径(LAD)均显著比对照组低,试验组术后3 d左室射血分数(LVEF)明显比对照组高,试验组并发症发生率(2.22%)明显比对照组(13.33%)低,试验组术后2月SF-36评分明显高于对照组,比较差异均具有统计学意义(P<0.05)。结论:经胸小切口封堵术可有效改善ASD患者心功能,且手术时间短、并发症少,患者生活质量明显提升,疗效显著。
Abstract:
Objective:To analyze the efficacy of transthoracic small incision closure in the treatment of atrial septal defect(ASD)and its effect on cardiac function.Methods:180 ASD patients were selected and randomly divided into control group and experimental group,90 patients in each group.The control group was treated with sternal midline thoracotomy septal defect repair,and the experimental group was given transthoracic small incision ASD closure.Surgical indicators,cardiac function indicators,and complication rates between the two groups were compared.Followed up for 2 months,and the SF-36 scores was compared between the two groups.Results:The operation time,ventilator deactivation time,intensive care time and incision length of the experimental group were significantly shorter than those of the control group.The postoperative drainage volume of the experimental group was significantly shorter than that of the control group.LVEDD and LAD in the experimental group were significantly lower than those in the control group at 3 days after surgery.The incidence of complications in the experimental group(2.22%)was significantly lower than that(13.33%)in the control group(P<0.05).The SF-36 score of the experimental group was significantly higher than that of the control group at 2 months after surgery.Conclusion:Transthoracic small incision closure can effectively improve the cardiac function of patients with ASD,and the operation time is short,the complications are less,the quality of life of the patients is significantly improved,and the efficacy is significant.

参考文献/References:

[1] 梁 毅.胸腔镜下心脏术后并发症的预防及临床研究[J].陕西医学杂志,2019,48(1):25-27.
[2] 赖文豪,谢少波,邝素华,等.经胸微创封堵手术与传统外科修补手术治疗房间隔缺损的系统评价及Meta分析[J].中国胸心血管外科临床杂志,2019,26(8):795-804.
[3] 龙超众,冯耀光,贺大璞,等.全胸腔镜及常规开胸手术对成人房间隔缺损治疗的临床比较分析[J].中国医师杂志,2017,19(4):568-570.
[4] Mendirichaga R,Smairat RA,Sancassani R.Late tissue erosion after transcatheter closure of an atrial septal defect.[J].Catheterization & Cardiovascular Interventions,2017,89(3):502-504.
[5] 罗 刚,张 蔼,陈涛涛,等.孕27周胎儿左心发育不良综合征-限制性房间隔缺损宫内介入治疗1例[J].中华实用儿科临床杂志,2019,34(13):1025-1026.
[6] 张大伟,潘湘斌,李 萍,等.单纯超声引导经颈静脉封堵治疗婴幼儿房间隔缺损[J].中华医学杂志,2019,99(6):458-461.
[7] 李海洋,戴 璐,许士俊,等.成人先天性房间隔缺损或室间隔缺损合并升主动脉扩张的治疗[J].中华胸心血管外科杂志,2018,34(6):356-358.
[8] 朱全伟,王 宁,高明磊,等.经胸超声心动图引导可调弯鞘右侧颈内静脉途径封堵小儿房间隔缺损[J].中国微创外科杂志,2019,19(10):878-881.
[9] Guo ZX,Zhang CX,Wang H,et al.Peratrial device closure of atrial septal defect under transesophageal echocardiographic guidance without fluoroscopy compared to conventional on-pump surgical closure[J].Brazilian Journal of Cardiovascular Surgery,2017,32(1):38-42.
[10] 任永凤,王 洲,陈德海,等.经食道超声引导下外科微创封堵术治疗先天性心脏病的应用研究[J].中华全科医师杂志,2019,18(8):772-774.
[11] 刘宇航,王 宁,赵 烨,等.经胸微创介入术治疗小儿先天性心脏病复合畸形的疗效[J].中华实用儿科临床杂志,2018,33(13):1018-1021.
[12] 窦 志,谢 琦,翁国星,等.经胸超声与经食管超声引导下经皮房间隔缺损封堵术的比较研究[J].中华胸心血管外科杂志,2018,34(9):522-526.
[13] 邢泉生,武 钦.心脏间隔缺损生物可降解封堵器的研究进展[J].中华胸心血管外科杂志,2017,33(6):380-384.
[14] 李延军,刘 罡,杜德禄,等.超声引导下经皮室间隔缺损封堵术与经胸小切口室间隔缺损封堵术疗效比较[J].新乡医学院学报,2019,36(3):262-264.
[15] Javed S,Li GS,Li MJ,et al.Quantitative assessment of intra-cardiac dissipative energy loss derived from vector flow mapping in patients with atrial septal defect[J].Journal of Medical Imaging & Health Informatics,2017,7(6):1219-1225.
[16] 林 巍,符芳永,卢 伟,等.经胸小切口非体外循环房间隔缺损封堵术的安全性和有效性[J].中国临床研究,2018,31(11):63-65,69.

更新日期/Last Update: 2021-01-05