经胸微创介入封堵术治疗先天性心脏病的疗效

发布时间：2019-04-19 05:12

【摘要】：目的探讨经胸微创介入封堵术治疗先天性心脏病的手术方式及其疗效。方法选取80例先天性心脏病患者,男42例、女38例,年龄1~50岁,体重8~65kg,其中继发孔型房间隔缺损(ASD)25例、动脉导管未闭(PDA)13例、室间隔缺损(VSD)42例,均于全身麻醉、非体外循环、超声引导下经胸由输送器置入封堵器闭合缺损部位。结果本组80例患者手术均获成功,平均手术时间为(65.2±13.4)min,平均术中失血量为(30.0±11.2)mL。无1例患者死亡。3例ASD患者因缺损较大,术中封堵器脱落,利用"风筝线"技术顺利取出封堵器,更换大号封堵器,经2次调整后封堵成功;其他患者均一次封堵成功。2例ASD患者术后出现肺动脉高压危象,经治疗后好转,心功能改善。所有患者平均住院时间为(5±2)d,术后平均随访时间为(18±3)个月,随访期间均无封堵器移位和残余分流发生。结论经胸微创介入封堵术治疗先天性心脏病是一种简便和安全有效的方法。
[Abstract]:Objective to investigate the surgical method and curative effect of transthoracic minimally invasive interventional occluder for congenital heart disease. Methods 80 patients with congenital heart disease, 42 males and 38 females, aged 1-50 years and weighing 8-65 kg, were enrolled in this study. There were 25 cases of secundum atrial septal defect (ASD), 13 cases of patent ductus arteriosus (PDA) and 42 cases of ventricular septal defect (VSD). All the patients were closed by transthoracic occluder under general anesthesia, off-pump circulation and ultrasound-guided transthoracic occluder. Results the average operative time was (65.2 卤13.4) min, and the mean intraoperative blood loss was (30.0 卤11.2) mL.. None of the patients died, 3 patients with ASD had large defect and the occluder fell off during the operation. The occluder was removed successfully by kite line technique, and the large occluder was replaced. After twice adjustment, the occluder was successfully occluded. The other patients were successfully occluded at one time. Pulmonary hypertension crisis was found in 2 patients with ASD after treatment, and cardiac function was improved. The average hospitalization time was (5 卤2) days, and the mean follow-up time was (18 卤3) months. No occluder displacement or residual shunt occurred during the follow-up period. Conclusion Transthoracic minimally invasive interventional occlusion is a simple, safe and effective method for congenital heart disease.
【作者单位】：南昌大学第一附属医院心胸外科;
【基金】：江西省教育厅支撑项目资助(GJJ12115)
【分类号】：R654.2

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