食管超声引导下经胸外科封堵治疗先天性心脏病的疗效

目的 探讨食管超声引导下经胸外科封堵术治疗先天性心脏病的疗效和预后.方法 选取2016年1月至2018年12月在我院行食管超声引导下经胸外科封堵治疗的先天性心脏病患者52例为研究组,同期行体外循环下修补治疗患者53例为对照组,记录并比较两组患者手术时间、术中出血量、输血量、呼吸机辅助时间、ICU停留时间、血管活性药物使用情况及术后住院时间、并发症发生率等指标,术前及出院前均采用经胸超声心动图对患者心脏结构功能进行评价,术后随访12个月观察预后情况.结果 两组患者全部手术成功,均无死亡和危及生命的严重并发症.研究组手术时间(72.69±6.14)min、术中出血量(29.96±5.99)ml、输血比例(1.92%)、呼吸机辅助时间(132.70±13.21)min、ICU停留时间(11.85±1.43)h、住院时间(6.83±0.49)d均明显少于对照组的(130.50±3.53)min、(112.80±11.93)ml、(28.30%)、(217.20±19.02)min、(20.60±0.71)h、(8.34±0.39)d(P<0.01).血管活性药物使用比例(32.69%)也明显低于对照组(90.57%),两组总并发症发生的差异也有统计学意义.术后3、6、12个月随访超声心动图检查示,52例患者封堵器均位置良好,未见残余分流及血栓形成,心电图也未见严重心律失常.结论 食管超声引导下经胸外科封堵治疗先天性心脏病是一种安全有效的方法,具有创伤小、易操作、恢复快等优点.

Effects of transesophageal echocardiography guide on transthoracic surgical closure for congenital heart disease

Objective To investigate the efficacy and prognosis of transesophageal echocardiography guide on transthoracic surgical closure for congenital heart disease.Methods From January 2016 to December 2018,52 patients with congenital heart disease who underwent transesophageal echocardiography guide in transthoracic surgical closure of the Seventh People's Hospital of Zhengzhou were selected as the study group.53 patients who underwent extracorporeal circulation repair were selected as the control group in the same period.The operation time,intraoperative blood loss,ventilator assist time,ICU stay time,vasoactive drug use,postoperative hospital stay and complication rate were recorded and compared between the two groups.Evaluation of cardiac structural function in patients before and after discharge by transthoracic echocardiography.Prognosis was observed after 12 months of follow-up.Results All the patients in the two groups were successful,with no deaths and serious life-threatening complications.The operation time(72.69±6.14)min,intraoperative blood loss(29.96±5.99)ml,transfusion ratio(1.92%),ventilator assist time(132.70±13.21)min,ICU length of stay(11.85±1.43)hours and hospitalization time(6.83±0.49)days of the study group were significantly less than those of the control group(130.50±3.53)min,(112.80±11.93)ml,(28.30%),(217.20±19.02)min,(20.60±0.71)hours,(8.34±0.39)days(P<0.01).The proportion of vasoactive drugs(32.69%)was also significantly lower than that of the control group(90.57%)and the difference in the incidence of total complications between the two groups was also statistically significant.Echocardiography at 3,6 and 12 months after surgery showed that 52 patients had good occlusion devices and no residual shunt and thrombosis were observed.There was no serious arrhythmia in the electrocardiogram.Conclusion Transesophageal echocardiography guide in transthoracic surgical closure for congenital heart disease is a safe and effective method with smaller trauma,easier operation and quicker recovery.