介入封堵术与外科手术治疗膜周部室间隔缺损效果的观察

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目的 探讨介入封堵术对膜周部室间隔缺损的即时治疗效果,并与同期外科手术效果进行对比。方法 采用封堵术治疗膜周部室间隔缺损患儿4 8例,与同一时期采用外科手术治疗的73例患儿,进行年龄、身高、体重、肺动脉压力、室间隔缺损大小、手术及住院时间、手术成功率及并发症的比较。两组间均数的比较采用t检验,率的比较采用卡方检验。结果 两组小儿的年龄、身高、体重、肺动脉压力及手术成功率差异无统计学意义。封堵术组的室间隔缺损较手术组的小,但手术及住院时间较短。封堵组术中及术后出现左前分支或完全性左束支阻滞较多见,其他并发症包括再次外科手术、残余分流、术中出血多、神经受损、溶血、术中或术后Ⅲ度房室传导阻滞、气胸、胸腔积液、心包积液、主动脉关闭不全及术后感染在两组间差异无统计学意义。结论 室间隔缺损封堵术作为治疗室间隔缺损的新方法,即时的疗效确切。采用封堵术治疗室间隔缺损应遵循治疗原则,术中遵守操作规范,术后严密观察,从而减少并发症的发生。 Objective To investigate the immediate effect of interventional closure on ventricular septal defect of the peritoneum and to compare with the surgical results in the same period. Methods Forty-eight cases of VSD with peritoneal septum defect were treated by occlusion. 73 cases with surgical treatment were performed in the same period. Age, height, weight, pulmonary artery pressure, size of ventricular septal defect, operation and hospital stay, Surgical success rate and complication comparison. Comparison of mean between the two groups using t test, the rate of comparison using chi-square test. Results There was no significant difference in age, height, weight, pulmonary artery pressure and operation success rate between the two groups. Ventricular septal defect in the closure group was smaller than that in the surgical group, but the operation and hospitalization time were shorter. In the occlusion group, left anterior branch or complete left bundle branch block occurred during and after operation. Other complications included re-operation, residual shunt, intraoperative bleeding, nerve damage, hemolysis, intraoperative or postoperative Ⅲ degree atrioventricular block, pneumothorax, pleural effusion, pericardial effusion, aortic insufficiency and postoperative infection was no significant difference between the two groups. Conclusion Ventricular septal defect occlusion as a new method of treatment of ventricular septal defect, immediate effect is accurate. The use of closure surgery for the treatment of ventricular septal defect should follow the principle of treatment, intraoperative compliance with operating specifications, strict observation after surgery, thereby reducing the incidence of complications.
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