导管介入封堵治疗先天性心脏病患儿室间隔缺损的疗效观察
Observation on the therapeutic effect of catheter intervention occlusion in the treatment of ventricular septal defect in children with congenital heart disease
刘慧敏 1陈梅 1闵卫红 1孟影1
作者信息
- 1. 南京医科大学附属儿童医院 心血管内科,江苏 南京 210000
- 折叠
摘要
目的:观察导管介入封堵治疗先天性心脏病患儿室间隔缺损(VSD)的临床疗效.方法:采用方便抽样法纳入本院收治的216 例室间隔缺损先心病患儿作为研究对象,根据治疗方式的不同分为两组,介入组(116 例)行导管介入封堵治疗和手术组(100 例)行传统外科手术治疗.对两组患儿的手术疗效、术后并发症及恢复情况等进行回顾性对比分析.结果:与手术组相比,介入组的手术时间更短、术中输血量更少,差异有统计学意义(t =32.269、11.677,P<0.05).两组的手术成功率分别为98.28%和98.00%,差异无统计学意义(χ2 =0.127,P>0.05).介入组术后气管插管时间、术后住院时间均明显比手术组更短(t =19.278、13.148,P<0.05).两组的住院费用比较,差异无统计学意义(t =0.308,P>0.05).两组手术前后心室肌除极时间(QRS间期)差值差异有统计学意义(t =23.868,P<0.05).介入组术后的感染发生率显著低于手术组(t =10.078,P<0.05),但心律失常发生率显著高于手术组(t =14.343,P<0.05).介入组未发生严重并发症,手术组的严重并发症发生率为7.00%,显著高于介入组(χ2 =8.392,P<0.05).结论:导管介入封堵治疗小儿VSD的疗效确切,术后严重并发症少,但术后心律失常发生率较高,术中有必要合理控制封堵器与重要传导系统的安全距离.
Abstract
Objective:To observe the clinical effect of transcatheter closure of ventricular septal defect(VSD)in children with congenital heart disease.Methods:216 cases of congenital heart disease with VSD in our hospital by convenience sampling method were included in the study,and were divided into two groups according to the different treatment methods,intervention group(116 cases)underwent catheter intervention occlusion treatment and surgery group(100 cases)underwent traditional surgical treatment.The surgical efficacy,postoperative complications and recovery of the children in the two groups were analyzed retrospectively.Results:Compared with the surgery group,the intervention group had a shorter procedure time and less intraoperative bleeding,and the difference was statistically significant(t =32.269,11.677,P<0.05).The success rates of surgery in the two groups were98.28%and 98.00%,respectively,and the difference was not statistically significant(χ2 =0.127,P>0.05).The postoperative tracheal intubation time and hospitalization time were significantly shorter in the intervention group than in the surgery group(t =19.278,13.148,P<0.05).There was no statistically significant difference in hospitalization costs between the two groups(t =0.308,P>0.05).The differences in ventricular myocardial depolarization time(QRS interval)before and after the operation between the two groups was statistically significant(t = 23.868,P<0.05)The incidence of postoperative infection in the intervention group was significantly lower than that in the surgery group(t =10.078,P<0.05),but the incidence of arrhythmia was significantly higher than that in the surgery group(t =14.343,P<0.05).There were no serious complications in the intervention group,and the incidence of serious complications in the surgery group was 7.00%,significantly higher than that in the intervention group(χ2 = 8.392,P<0.05).Conclusion:The efficacy of catheter intervention occlusion in the treatment of pediatric VSD is definite,with fewer severe postoperative complications.However,the incidence of postoperative arrhythmia is relatively high.It is necessary to reasonably control the safe distance between the occluder and important conduction systems during surgery.
关键词
导管介入封堵治疗/先天性心脏病/室间隔缺损/心律失常Key words
transcatheter closure/congenital heart disease/ventricular septal defect/arrhythmias引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据