杜朝峻, 丁力, 李红昕, 郭文斌, 吴鹏鹏, 马佳佳. 食管超声引导下经胸微创封堵术治疗小儿室间隔缺损的临床疗效及预后分析[J]. 蚌埠医学院学报, 2021, 46(5): 645-648. DOI: 10.13898/j.cnki.issn.1000-2200.2021.05.022
    引用本文: 杜朝峻, 丁力, 李红昕, 郭文斌, 吴鹏鹏, 马佳佳. 食管超声引导下经胸微创封堵术治疗小儿室间隔缺损的临床疗效及预后分析[J]. 蚌埠医学院学报, 2021, 46(5): 645-648. DOI: 10.13898/j.cnki.issn.1000-2200.2021.05.022
    DU Chao-jun, DING Li, LI Hong-xin, GUO Wen-bin, WU Peng-peng, MA Jia-jia. Study on the clinical effects and prognosis of minimally invasive transthoracic occlusion guided by esophageal ultrasound in the treatment of ventricular septal defect in children[J]. Journal of Bengbu Medical College, 2021, 46(5): 645-648. DOI: 10.13898/j.cnki.issn.1000-2200.2021.05.022
    Citation: DU Chao-jun, DING Li, LI Hong-xin, GUO Wen-bin, WU Peng-peng, MA Jia-jia. Study on the clinical effects and prognosis of minimally invasive transthoracic occlusion guided by esophageal ultrasound in the treatment of ventricular septal defect in children[J]. Journal of Bengbu Medical College, 2021, 46(5): 645-648. DOI: 10.13898/j.cnki.issn.1000-2200.2021.05.022

    食管超声引导下经胸微创封堵术治疗小儿室间隔缺损的临床疗效及预后分析

    Study on the clinical effects and prognosis of minimally invasive transthoracic occlusion guided by esophageal ultrasound in the treatment of ventricular septal defect in children

    • 摘要:
      目的比较食管超声引导下经胸微创封堵术与传统修补术在治疗小儿室间隔缺损上的临床疗效。
      方法选择接受传统开胸修补术的89例室间隔缺损患儿与接受食管超声引导下经胸微创封堵术的85例室间隔缺损患儿作为研究对象,分别设为对照组和观察组,比较2组患儿手术情况、术后炎症因子指标、术后并发症发生情况、术后恢复时间及心功能指标。
      结果观察组手术时间明显短于对照组(P < 0.01),术中无输血,明显低于对照组的输血量(407.87±95.89)mL(P < 0.01);观察组术后第1~3天的C反应蛋白和白细胞计数均低明显于对照组(P < 0.01);观察组术后并发症总发生率与对照组差异无统计学意义(P>0.05)。观察组术后呼吸机支持时间、住院时间均明显短于对照组(P < 0.01)。2组手术后的左心室射血分数、左心室舒张末期内径、左心室收缩末期内径水平与手术前比较均明显改善(P < 0.01);且手术后,观察组左心室射血分数高于对照组,左心室舒张末期内径和左心室收缩末期内径均明显低于对照组(P < 0.01)。
      结论食管超声引导下经胸微创封堵术在小儿室间隔缺损治疗中可缩短手术时间、减少术中输血量等,有利于减轻术后炎症反应,降低术后并发症风险,加快术后康复进展,改善心功能。

       

      Abstract:
      ObjectiveTo compare the clinical effects between minimally invasive transthoracic occlusion guided by esophageal ultrasound and conventional repair in the treatment of ventricular septal defect(VSD) in children.
      MethodsEighty-nine VSD children treated with traditional thoracotomy repair and 85 VSD children treated with minimally invasive transthoracic occlusion guided by esophageal ultrasound were divided into the control group and observation group, respectively.The surgical situation, postoperative inflammatory factors, postoperative complications, postoperative recovery time and cardiac function indexes were compared between two groups.
      ResultsThe operation time in observation group was shorter than that in control group(P < 0.01), and the intraoperative blood transfusion amount in observation group(0 mL) was less than that in control group(407.87±95.89)mL(P < 0.01).On the postoperative 1 to 3 days, the C-reactive protein level and leukocyte count in observation group were lower than those in control group(P < 0.01).The difference of the total incidence rate of postoperative complication between two groups was not statistically significant(P>0.05).The intubation time and hospital stay in observation group were shorter than those in control group(P < 0.01).After operation, the levels of LVEF, LVEDD and LVESD in two groups were significantly improved compared with those before operation(P < 0.01).After operation, the level of LVEF in observation group was higher than that in control group, and the levels of LVEDD and LVESD in observation group were lower than those in control group(P < 0.01).
      ConclusionsThe minimally invasive transthoracic occlusion guided by esophageal ultrasound in treating VSD of children can significantly shorten the operation time and reduce intraoperative blood transfusion amount.It is beneficial to reduce postoperative inflammatory reaction, reduce the risk of postoperative complications, accelerate the progress of postoperative rehabilitation and improve cardiac function.

       

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