经胸小切口非体外循环房间隔缺损封堵术的安全性和有效性

Safety and efficacy of transthoracic small incision off-pump ASD occlusion

目的探究经胸小切口非体外循环封堵术治疗房间隔缺损(ASD)的安全性与有效性。方法对2015年10月至2017年10月经胸非体外循环小切口封堵术治疗的40例ASD患者(观察组)进行回顾性研究,以同期接受传统体外循环直视修补术的40例ASD患者作为对照组。比较两组手术成功率、临床相关指标和术后并发症发生情况。结果两组手术成功率均为100%,但观察组手术时间、术后住院时间、术后下地时间、输血量和切口长度均少于对照组(P均<0. 01);两组术前、术后6个月时左室收缩末容积(ESV)、左室射血分值(LVEF)和左室短轴缩短率(FS)的组间、组内比较差异均无统计学意义(P均> 0. 05);观察组术后并发症发生率低于对照组,差异有统计学意义(2. 5%vs 20. 0%,P <0. 05)。结论经胸小切口非体外循环封堵术治疗ASD疗效理想,术后并发症发生率低,具有较高的安全性,是治疗ASD的有效方法。

Objective To explore the safety and efficacy of atrial septal defect（ASD） occlusion by transthoracic small incision off-pump. Methods A retrospective study was performed in 40 patients（observation group） receiving transthoracic small incision off-pump ASD occlusion from October 2015 to October 2017. At the same time,40 ASD patients receiving traditional cardiopulmonary bypass（CPB） direct visual repair were served as control group. The operative success rate,clinical-related indexes and postoperative complications were compared between two groups. Results The success rate of operation was 100% in both two groups,but the operation time,postoperative hospital stay,postoperative time out of bed,blood transfusion volume and incision length in observation group were significantly lower than those in control group（all P〈0. 01）. There were no significant differences in the left ventricular end systolic volume（ESV）,left ventricular ejection fraction（LVEF） and left ventricular short axis shortening rate（FS） of intragroupandintergroup before and 6 months after operation. The incidence of postoperative complications in observation group was significantly lower than that in control group（2. 5% vs 20. 0%,P〈0. 05）. Conclusion Transthoracic small incision off-pump occlusion is an effective method for the treatment of ASD,with a low incidence of postoperative complications and high safety.