比较食管超声引导下两种经胸微创封堵术治疗房间隔缺损的效果

Clinical comparison of two transthoracic microoccluders in the treatment of atrial septal defect

目的比较食管超声(TEE)引导下经胸骨旁和经右腋下封堵术治疗继发孔型房间隔缺损(ASD)的优缺点,为ASD患者提供个体化治疗方案。方法选取郑州大学第一附属医院心血管外科2015-06—2018-03间收治的143例继发孔型ASD患者,根据不同术式将其分为2组。A组在TEE引导下经胸骨旁封堵术,B组实施经右腋下封堵术。回顾分析两种术式的优缺点。结果A组手术时间、切口长度、术后短期并发症均明显少于B组,差异均具有统计学意义(P<0.05)。结论TEE引导下两种封堵术均为治疗继发孔型ASD的有效手段。其中经胸骨旁封堵术因具有术中操作时间较短、切口小、术后并发症少等优点,可作为首选。

Objective To retrospectively analyze the advantages and disadvantages of transsphenoidal and right axillary occlusion in the treatment of secondary atrial septal defect (ASD) under esophageal superconducting (TEE),and to provide individualized treatment for patients.Methods A total of 143 patients with secondary ASD were selected from the Department of Cardiovascular surgery of the first affiliated Hospital of Zhengzhou University.They were divided into two groups according to different operation methods: group A was transsternal closure under the guidance of TEE,and group B was occluded through right subaxillary.Review and Analysis of the advantages and disadvantages of the two methods.Results The operative time,incision length and short-term complications in group A were significantly shorter than those in group B ( P <0.05 ).Conclusion Both TEE-guided transcatheter closure are effective methods for the treatment of secondary ASD.Transsternal closure can be used as the first choice because of its advantages such as shorter operation time,smaller incision,less postoperative complications and so on.