食管超声引导下经胸房间隔缺损封堵术的应用研究

Application of the transthoracic occlusion surgery of atrial septal defect under the guidance of transesophageal echocardiography

目的:探讨食管超声引导下经胸房间隔缺损封堵术的可行性及其优越性。方法:选取我科2009年9月至2014年8月经胸及经食管超声诊断为房间隔缺损患者共54例为试验组,选取同期行体外循环下房缺修补术31例患者为对照组,应用SPSS 16.0统计软件在手术时间、呼吸机辅助时间、术后住院天数、伤口大小及心理认可状况方面进行对比研究。结果:试验组手术时间(81.13±15.91)min,呼吸机辅助时间(193.67±72.74)min,伤口大小(3.41±1.13)cm,术后住院天数(3.37±0.49)d,心理认可状况54例均良好。对照组手术时间(109.13±18.19)min,呼吸机辅助时间(425.06±40.67)min,伤口大小(10.78±1.37)cm,术后住院天数(9.61±1.69)d。患者心理认可状况:良好8例,一般10例,较差13例。各项对比结果试验组明显优于对照组(P<0.05)。结论:食管超声引导下经胸房间隔缺损封堵术既缩短手术时间和呼吸机辅助时间,降低术后住院天数和费用,又符合美容要求,患者心理认可状况良好,是一种安全可行的手术方法。

Objective： To explore the feasibility and advantage of the transthoracic occlusion surgery of atrial septal defect（ ASD） under the guidance of transesophageal echocardiography（ TEE）. Methods： In experimental group,fifty-four patients with ASD were examined by transthoracic echocardiography and TEE from September 2009 to August 2014 in our hospital. In control group,thirty-one patients were eligible for repairing of ASD under cardiopulmonary bypass. For the comparative study,we used SPSS 16. 0 to study these indicators： the operation time,the breathing machine auxiliary time, the postoperative hospitalization days, the wound length and psychological recognition. Results： In experimental group,the operation time was（ 81. 13 ± 15. 91） min,the breathing machine auxiliary time was（ 193. 67 ± 72. 74） min,the wound length was（ 3. 41 ± 1. 13） cm,the mean postoperative hospitalization days were（ 3. 37 ± 0. 49） days. All of them had a good psychological recognition. In control group,the operation time was（ 109. 13 ± 18. 19） min,the breathing machine auxiliary time was（ 425. 06 ±40. 67） min,the wound length was（ 10. 78 ± 1. 37） cm,the postoperative hospitalization days were（ 9. 61 ±1. 69） days. The psychological recognition： 8 patients were good,10 patients were neutral,13 patients were poor.The results in experimental group were better than those in control group（ P 0. 05）. Conclusion： The transthoracic occlusion surgery of ASD under the guidance of TEE is a safe and feasible operation style,it can reduce operation time,breathing machine auxiliary time,the postoperative hospitalization days and the costs,meet a cosmetic requirement and get a good psychological recognition.