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镶嵌技术治疗婴幼儿室间隔缺损的效果观察

Inlay Approach for the Infant with Ventricular Septal Defect
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摘要 目的探讨镶嵌技术治疗婴幼儿室间隔缺损(VSD)的可行性与安全性。方法回顾性分析2010年6月至2013年12月解放军第四五四医院心胸外科采用镶嵌技术治疗279例婴幼儿VSD的临床资料,按是否有体外循环参与分为非体外循环组(201例)、体外循环组(78例)。以同期常规体外循环下VSD修补手术65例作为对照组。对比3组患儿手术时间、术后机械通气时间、ICU停留时间、术后住院时间、围术期并发症发生率、住院总费用。结果 3组围术期均无死亡。非体外循环组手术时间、术后机械通气时间、ICU停留时间、术后住院时间分别为(1.3±0.4)h、(2.5±0.8)h、(17.8±3.8)h、(6.7±1.7)d,短于对照组的(3.0±0.5)h、(13.6±6.6)h、(38.4±4.2)h、(12.0±1.8)d和体外循环组的(2.7±0.4)h、(47.1±22.8)h、(58.9±26.0)h、(11.6±3.0)d,差异有统计学意义(P<0.05);非体外循环组并发症发生率低于体外循环组和对照组(P<0.05)。结论镶嵌技术在治疗婴幼儿VSD方面具有安全性好、严重并发症少等优点。 Objective To investigate the feasibility and safety of inlay approach treatment for infant with ventricular septal defect(VSD).Methods Retrospective analysis on 279 infant from PLA 454th Hospital with VSD who received inlay approach from Jun.2010 to Dec.2013,was done.According to whether cardiop-ulmonary bypass was involved, they were divided into off-pump group ( 201 cases ) , and on-pump group (78 cases) .And 65 cases who received conventional VSD repair on-pump during the same period were included as control group.Operation time, postoperative mechanical ventilation time, intensive care unit (ICU) stay time,postoperative hospital stay,the rate of complications in perioperative period and the total cost of hospitalization of the three groups were compared .Results All of the three groups had no death dur-ing perioperative period.Operation time,postoperative mechanical ventilation time,ICU stay time,postopera-tive hospital stay of off-pump inlay approach group were (1.3 ±0.4) h,(2.5 ±0.8) h,(17.8 ±3.8) h, (6.7 ±1.7) d,which were shorter than those in the control group [(3.0 ±0.5) h,(13.6 ±6.6) h, (38.4 ±4.2) h,(12.0 ±1.8) d] and inlay approach group with cardiopulmonary bypass [(2.7 ±0.4) h, (47.1 ±22.8) h,(58.9 ±26.0) h,(11.6 ±3.0) d],the difference were statistically significant(P 〈0.05).The rate of complications in perioperative period of off-pump inlay approach group were lower than control group and on-pump inlay approach group(P〈0.05).Conclusion Inlay approach has the advanta-ges of good safety,fewer complications for the infant with VSD.
出处 《医学综述》 2015年第14期2628-2631,共4页 Medical Recapitulate
基金 江苏省临床医学科技专项基金(BL2013003)
关键词 室间隔缺损 镶嵌技术 先天性心脏病 婴幼儿 Ventricular septal defect Inlay approach Congenital heart disease Infant patient
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