室间隔缺损3种不同手术方式对心脏瓣膜功能影响的对比分析

发布时间：2018-05-21 10:56

本文选题：室间隔缺损 + 经皮导管介入封堵术　；参考：《福建医科大学》2015年硕士论文

【摘要】：目的:对经皮导管介入封堵术、经胸微创封堵术和直视修补术3种治疗室间隔缺损的手术方式对心脏瓣膜功能的影响进行回顾性对比分析,以助于室间隔缺损手术方式的合理化选择。方法:选用2013年1月-2015年1月,在福建医科大学附属协和医院心脏外科及心脏内科住院行手术治疗的单纯室间隔缺损患者263例,其中经胸微创封堵组(微创组)79例,经皮导管介入封堵术组(介入组)36例,直视修补术组(修补组)148例;对微创组、介入组及修补组在术后1周及3个月对三尖瓣关闭不全、三尖瓣狭窄及主动脉瓣关闭不全的发生率进行对比研究。两组间率的比较采用卡方检验。结果:在术后l周,介入组及微创组主动脉瓣关闭不全、三尖瓣关闭不全的发生率较修补组高(P0.05)。术后3个月,微创组、介入组及修补组的发生率差异无统计学意义(P0.05)。术后1周及3个月,微创组与修补组、介入组分别比较,三尖瓣狭窄的发生率差异无统计学意义(P0.05)。结论:经皮导管介入封堵术、经胸微创封堵术和直视修补术3种手术方式治疗对心脏瓣膜功能影响均较轻。应充分评估病情,严格掌握手术指证,选择合适的手术方式,避免粗暴动作,行封堵术时选择合适大小的封堵器,减少对瓣膜的影响。
[Abstract]:Objective: to compare and compare the effects of percutaneous catheter closure, transthoracic minimally invasive closure and open vision repair on the function of cardiac valve in patients with ventricular septal defect (VSD). Objective: to help the rational choice of the operation mode of ventricular septal defect (VSD). Methods: from January 2013 to January 2015, 263 cases of simple ventricular septal defect (VSD) were operated in the Department of Cardiac surgery and Cardiology, affiliated to Union Hospital of Fujian Medical University, including 79 cases in the minimally invasive transthoracic closure group (79 cases in the minimally invasive group). Percutaneous catheter closure was performed in 36 cases in the interventional group and 148 cases in the open vision repair group, and tricuspid insufficiency in the minimally invasive group, interventional group and repair group at 1 week and 3 months after operation. The incidence of tricuspid stenosis and aortic insufficiency was compared. The rates of the two groups were compared by chi-square test. Results: at 1 week after operation, the incidence of aortic insufficiency and tricuspid insufficiency in interventional group and minimally invasive group was higher than that in repair group (P 0.05). 3 months after operation, there was no significant difference in the incidence rate between the minimally invasive group, interventional group and repair group (P 0.05). 1 week and 3 months after operation, the incidence of tricuspid stenosis in the minimally invasive group was not significantly different from that in the repair group and interventional group (P 0.05). Conclusion: percutaneous catheter closure, transthoracic minimally invasive closure and open vision repair have slight effects on heart valve function. It is necessary to evaluate the condition of the disease strictly master the operation indication select the appropriate operation method avoid rough action and select the appropriate size occluder to reduce the influence on the valve.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.2

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