食管超声下经胸微创封堵术、改良修补术治疗小儿室间隔缺损的效果比较

Comparison the Effect of Trans-thoracic Minimally Invasive Closure and Modified Repair on the Treatment of Ventricular Septal Defect in Children under Esophageal Ultrasound

目的将食管超声引导下经胸微创封堵术与改良修补术在治疗小儿室间隔缺损的临床疗效进行对比分析。方法选取2016年1月-2019年1月进入河南省儿童医院的室间隔缺损的患儿100例,随机分为两组,改良术组(n=50)和封堵术组(n=50)。改良术组给予改良修补术治疗,封堵术组给予经胸微创封堵术治疗。记录两组的术中失血量、手术时间、ICU停留时间、住院时间,以及术后至出院并发症的发生情况,检测术后6个月的超声心动图。结果观察组患儿的手术、ICU停留、住院时间均短于对照组(P<0.05),术中出血量少于对照组(P<0.05);术后至出院,两组并发症的发生率无显著差异(P>0.05);术后6个月,与治疗前相比,两组患者的肺动脉瓣口血流速度、左室舒张末径、肺动脉内径均下降(P<0.05),主动脉瓣口血流速度升高(P<0.05)。结论改良修补术、微创封堵术治疗间隔室缺损均有良好的疗效,但微创封堵术能缩短治疗时间,创伤较小,利于患儿的康复。

Objective To analysis and comparison the clinical effect of ultrasound-guided trans-thoracic minimally invasive closure and modified repair on ventricular septal defect in children.Methods A total of 100 children with ventricular septal defect admitted to Henan children's hospital from January 2016 to January 2019 were randomly divided into two groups control group(n=50)and observation group(n=50).The improved surgery group was treated with modified repair,and the closure group was treated with trans-thoracic minimally invasive closure.The blood loss in operation,operation time,ICU stay time,hospital stays,and complications from post-operation to discharge of the two groups were recorded,and the echocardiography was detected at postoperative 6 months.Results The duration of operation,ICU stay and hospitalization in the observation group was shorter than those of the control group(P<0.05),and the blood loss in operation was less than that of the control group(P<0.05).From post-operation to discharge,there was no significant difference in the incidence of complications between the two groups(P>0.05).At postoperative 6 months,compared with before treatment,the blood flow velocity of pulmonary valve orifice,left ventricular end-diastolic diameter and pulmonary artery internal diameter were decreased both the group(P<0.05),while the blood flow velocity of the aortic valve orifice was increased(P<0.05).Conclusion Both modified repair and minimally invasive closure have good curative effects in the treatment of ventricular septal defect,but minimally invasive closure can shorten the treatment time and reduce the trauma,which is beneficial to the recovery of children.