经食管超声引导封堵治疗婴幼儿先心病的应用研究

Application Study of Transesophageal Ultrasound-guided Occlusion in the Treatment of Infants and Young Children with Congenital Heart Disease

目的:探讨经食管超声引导封堵治疗婴幼儿先天性心脏病(先心病)的应用效果。方法:选取2019年1-12月本院收治的婴幼儿先心病患儿130例,按随机数字表法分为研究组和对照组,各65例。研究组给予经食管超声引导下封堵治疗,对照组给予传统体外循环下开胸直视手术。比较两组患儿的手术相关指标、并发症发生情况及研究组中未能封堵成功者的转归。结果:两组患儿均痊愈出院,无死亡;研究组有62例封堵成功,成功率为95.38%;3例未能封堵成功,失败原因包括轨道建立困难、封堵器移位以及血色素尿,后期术式转为体外循环下开胸直视手术,手术均成功。研究组手术时间、术后机械通气时间、住院时间均明短于对照组(P<0.05);研究组并发症发生率为4.62%,低于对照组的12.31%,差异有统计学意义(P<0.05)。结论:食管超声引导下封堵治疗婴幼儿先心病的效果显著,能有效缩短手术时间、术后机械通气时间及住院时间,减少术后并发症的发生,值得临床推广应用。

Objective:To explore the effect of transesophageal ultrasound-guided occlusion in the treatment of congenital heart disease in infants and young children.Method:A total of 130 infants and young children with congenital heart disease admitted to our hospital from January to December 2019 were selected and divided into the study group and control group according to the principle of random grouping by numbers,with 65 cases in each group.The study group was given transesophageal ultrasound-guided congenital heart occlusion treatment,and the control group was given open thoracotomy under traditional cardiopulmonary bypass.The operation-related indicators,the occurrence of complications,and the outcome of those in the study group who failed to be successfully blocked were compared between the two groups.Result:Both groups were cured and discharged without death.In the study group,62 cases were successfully blocked,the success rate was 95.38%.3 cases were not successfully blocked,the reasons for the failure included difficulty in track establishment,displacement of occluder and hemoglobinuria,in the later stage,the operation was converted to open thoracotomy under cardiopulmonary bypass,and all the operations were successful.The operative time,postoperative mechanical ventilation time and hospital stay of the study group were significantly shorter than those of the control group(P<0.05).The complication rate in the study group was 4.62%,which was lower than 12.31%in the control group,the difference was statistically significant(P<0.05).Conclusion:Esophagus ultrasonic-guided occlusion has a significant effect on the treatment of congenital heart disease in infants,which can effectively shorten the operation time,postoperative mechanical ventilation time and hospitalization time,reduce the incidence of postoperative complications,and is worthy of clinical application.