经导管介入封堵术治疗室间隔缺损的临床效果

Clinical effect of transcatheter closure on ventricular septal defect

目的探讨经导管介入封堵术对室间隔缺损(VSD)患儿的临床疗效。方法选取2014年10月至2017年4月运城市中心医院收治的VSD患儿64例,根据治疗方案分为对照组与研究组,每组32例。对照组采用外科手术治疗,研究组采用经皮导管介入封堵术。治疗后比较两组治疗情况、并发症发生率、入院时及治疗后第6、24、48小时血清肌酸激酶同工酶(CK-MB)、肌钙蛋白(cTnI)水平。结果①研究组手术用时、住院费用、住院时间均少于对照组(P<0.05),研究组手术成功率(100.00%)与对照组(96.88%)比较,差异未见统计学意义(P>0.05);②治疗后第6、24、48小时,两组血清CK-MB水平与治疗前比较,差异未见统计学意义(P>0.05),且两组间比较差异亦未见统计学意义(P>0.05);③治疗后第6小时两组血清cTnI水平较治疗前增高(P<0.05),治疗后第24、48小时两组血清cTnI水平开始降低,与治疗后第6小时比较差异有统计学意义(P<0.05);治疗后不同时间两组血清cTnI水平比较差异未见统计学意义(P>0.05);④研究组并发症发生率(9.38%)低于对照组(31.25%),差异有统计学意义(P<0.05)。结论经导管介入封堵术治疗室间隔缺损效果显著,治疗成功率较高,可减少术后康复时间,对血清CK-MB、cTnI水平影响较小,仅引起心肌可逆性微损伤,安全性较高。

Objective To investigate the clinical effect of transcatheter closure on ventricular septal defect (VSD)in children.Methods The clinical data of 64 children with VSD who were treated in Yuncheng Central Hospital from October 2014 to April 2017 were selected and divided into control group and study group according to treatment protocols,with 32 cases in each group.Patients in control group were treated by surgery,and patients in study group were treated by percutaneous transcatheter closure.The treatment situation,incidence of complications,the levels of serum creatine kinase isoenzyme (CK-MB)and troponin (cTnI)at admission and 6,24 and 48 hours after treatment were compared between the two groups.Results ①The surgical time,hospitalization cost and hospital stay in study group were less than those in control group,and the difference was statistically significant (P<0.05).There was no significant difference in the surgical success rate between study group (100.00%, 32/32)and control group (96.88%,31/32),P>0.05.②There was no significant difference in serum CK-MB level between the two groups 6,24 and 48hours after treatment (P>0.05).③The serum cTnI level in the two groups at 6 hours after treatment was higher than that before treatment (P<0.05).The serum cTnI levels began to decrease at 24and 48hours after treatment,and they were significantly different from it at 6hours after treatment (P<0.05).There was no significant difference in serum level of cTnI between the two groups in any periods after treatment (P>0.05).④The incidence of complications in study group was 9.38%(3/32),which was lower than 31.25% in control group (10/32),P <0.05.Conclusions Transcatheter closure has great curative effect on VSD,of which the success rate is high.And it can reduce the postoperative rehabilitation time,has little influence on the levels of serum CK-MB and cTnI,and only cause myocardial reversible micro-injury,with high safety.