微创外科封堵术治疗婴幼儿房、室间隔缺损

Minimally invasive surgical closure in the treatment of infants with atrial septal defect and ventricular septal defect

摘要:

目的：观察微创外科封堵术治疗婴幼儿房间隔缺损（atrial septal defect，ASD）、室间隔缺损（ventricular septal defect，VSD）的疗效。方法：我科76例患儿成功行经食管心脏超声微创外科封堵术，对其手术时间、住院时间、并发症等进行统计分析，评价疗效。结果：76例患儿手术顺利，无死亡及封堵器脱落发生。ASD患儿28例，年龄6月～12岁，平均体质量13 kg，平均总住院时间10 d，平均手术时间75 min，术后使用呼吸机时间平均193 min，术后随访心脏彩超均提示封堵器位置良好，无残余分流、心律失常等并发症，VSD患儿48例，年龄1岁～12岁10月，平均体质量15 kg，平均总住院时间11 d，平均手术时间93 min，术后使用呼吸机时间平均170 min，术后随访彩超提示封堵器位置良好，无残余分流46例，2例极少量残余分流，1例出现室性早搏，1例不全性右束支传导阻滞。结论：微创外科封堵术是治疗儿童房、室间隔缺损的一种技术成熟，损伤小，术后恢复快，并发症少，可控性高，安全有效的方法，适合各年龄阶段婴幼儿。

Abstract:

Objective：To observe the clinical outcome of minimally invasive surgical closure treatment for infants with atrial septal de－fect（ASD） and ventricular septal defect（VSD）. Methods：There were 76 patients，who received minimally invasive surgical closure under transesophageal echocardiography. The operation time，duration of hospital stays，and complications were counted and analyzed. Results：The operations were smoothly for all 76 patients without any case of death and occluder falling off. Twenty-eight patients suf－fered from ASD with age of 6 months to 12 years，average body weight of 13 kg，average hospital stay of 10 d，average operation time of 75 min and average time using ventilator of 193 min after the operation. The echocardiography showed that the position of the oc－cluder was good without residual shunt or arrhythmia. Forty-eight patients suffered from VSD with age of 1-12 years，average body weight of 15 kg，average hospital stay of 11 d，average operation time of 93 min，average time using ventilator of 170 min after the operation. The echocardiography showed that the position of the occluder was good；46 patients had no residual shunt and two patents had very little shunt；one patient had premature ventricular premature beat and one patient had incomplete right bundle branch block. Conclusion：With the advantages of maturity，small damage，quick recovery，few complications，high safety and effectiveness，the mini－mally invasive surgical closure treatment is suitable for the infants with ASD and VSD at all agesperiods.