经胸微创封堵术在先天性心脏病患者中的临床效果及安全性研究

Study on clinical effect and safety of transthoracic minimally invasive occlusion in congenital heart disease sufferers

目的探讨经胸微创封堵术治疗先天性心脏病的临床效果以及安全性。方法选取2012-10—2015-10在郑州市儿童医院接受治疗的先天性心脏病患者160例,随机分为观察组与对照组。观察组采用经胸微创封堵术治疗,对照组采用传统的开胸修补术治疗。结果观察组住院时间、手术时间以及入住ICU时间明显短于对照组。经统计学检验,差异具有统计学意义(P<0.05)。观察组手术成功率为100.00%,封堵成功率为100.00%,术中出血量为(16.23±6.72)m L。对照组手术成功率为97.50%,封堵成功率为97.50%,术中出血量为(310.23±53.23)m L。两组手术成功率和封堵成功率差异无统计学意义(P>0.05),观察组术中出血量少于对照组(P<0.05)。观察组一过性心律失常1例,并发症发生率为1.25%。对照组术后一过性心率失常5例,心包积液2例,感染7例,并发症发生率为17.50%。观察组并发症发生率明显低于对照组(P<0.05)。结论经胸微创封堵术治疗先天性心脏病的临床效果显著,恢复快,并发症少,安全性高。

Objective To explore the clinical effect and safety of transthoracic minimally invasive occlusion in the treatment of congenital heart disease.Methods 160 cases with congenital heart disease treated at Zhengzhou Chil- dren＇s Hospital from October 2012 to October 2015 were selected and randomly divided into observation group and control group.The observation group were treated with transthoracic minimally invasive occlusion,while the control group were treated with traditional thoracotomy. Results The hospital stay, operation time and ICU stay were shorter in the observation group than in the control group, with differences of statistical significance（P〈 0.05）. In the observa- tion group, the success rate of operation was 100.00%, the success rate of occlusion was 100.00%, and the bleeding volume during operation was（t6.23 ＋ 6.72）mL.In the control group, the success rate of operation was 97.50%, the suc- cess rate of occlusion was 97.50%, and the bleeding volume during operation was（310.23 _＋ 53.23）mL.There was no significant difference in success rate of operation and occlusion between the two groups（P〉0.05）.The bleeding volume during operation in the observation group was less than that in the control group（P〈0.05）.In the observation group, there was 1 case of transient arrhythmia, with the incidence rate of complications of 1.25%.In the control group, there were 5 cases of transient arrhythmia, 2 cases of pericardial effusion and 7 cases of infection, with the incidence rate of complications of 17.50%.The incidence rate of complications in the observation group was significantly lower than that in the control group（P〈0.05）.Conclusion Transthoracic minimally invasive occlusion in the treatment of con- genital heart disease has a significant clinical effect, with rapid recovery, few complications and high safety.