儿童膜周部室间隔缺损介入与开胸治疗疗效比较研究

A comparative study of the efficacy of ventricular septal defect in membrane position between interventional radiology and thoracotomy in children

目的比较外科开胸修补和介入治疗两种方法治疗儿童膜周部先天性室间隔缺损的疗效。方法收集室间隔缺损(VSD)患儿384例,行外科开胸修补202例(开胸组),行介入封堵182例(介入组)。比较两组的手术时间、成功率、术中及术后输血量、并发症发生率、术后恢复时间、术后ICU监护时间、体外循环(CPB)时间、心包引流时间、机械通气时间。结果介入组无需输血、ICU监护、心包引流、机械通气等。而开胸组输血量为(372.45±200.88)mL,术后ICU监护时间为(3.21±2.17)d,CPB时间为(71.09±34.92)min,心包引流时间为(3.52±1.22)d,机械通气时间为(67.09±43.83)min。两组在手术时间和术后恢复时间上,介入组的时间明显少于开胸组(P<0.05)。介入组术后并发症发生率显著低于开胸组(P<0.05)。结论在相同的适应证情况下,介入治疗更有利于患儿身心健康。

Objective To compare surgical and interventional treatment in congenital ventricular septal defect in membrane position.Methods Among ventricular septal defect（VSD）in 384 cases in children,202 cases had surgical repair thoracotomy（thoracotomy group）,and 182 cases had interventional treatment（intervention group）.The comparison items included operative time,success rate,intraoperative and postoperative blood transfusion,complication rate,postoperative recovery for several days after ICU monitoring time,CPB time,pericardial drainage time,duration of mechanical ventilation.Results Children in the intervention group did not need blood transfusions,ICU care,pericardial drainage,mechanical ventilation.In the thoracotomy group,the blood transfusion was（372.45±200.88）mL,postoperative ICU monitoring time was（3.21±2.17）days,CPB time was（71.09±34.92）minutes,pericardial drainage time was（3.52±1.22）days,mechanical ventilation time was（67.09±43.83）minutes.The operative time and postoperative recovery time in the intervention group was significantly shorter than thoracotomy group（P〈0.05）.The incidence of postoperative complications in the intervention group was significantly lower than thoracotomy group（P〈0.05）.Conclusion Under the circumstances of the same indication,the interventional treatment is more beneficial to physical and mental health of children.