继发孔房间隔缺损的Amplatzer封闭器介入外科手术治疗的对比研究

目的　对继发孔房间隔缺损 (ASDⅡ )的Amplatzer间隔封闭器 (ASO)介入和外科治疗的疗效和安全性进行比较研究。方法　 1998年 5月～ 2 0 0 2年 12月接受ASO治疗的 72例和接受外科手术治疗的 6 6例ASDⅡ病人进行对比研究。结果　ASO组和外科组技术成功率分别为 97.2 % (70 /72例 )和 10 0 % ;ASO组的手术和住院时间明显短于外科组 (71.8± 11.6 )min和 (15 8.4± 31.8)min ;(8.8± 2 .3)d和 (2 6 .9± 9.9)d ,(P<0 .0 5 ) ;ASO组的手术并发症发生率明显低于外科组 (7.1%和 2 2 .7% ,P <0 .0 5 ) ;ASO组无病人接受输血 ,外科组接受输血率 89.1% (5 9/6 6例 ) ;ASO组费用明显高于外科组 (4 .4 5± 0 .5 3)万元和 (1.87± 0 .5 4 )万元 ,(P <0 .0 5 )。结论　继发孔ASD的ASO治疗在有适应症的范围内可替代外科手术 ,降低ASO费用有助于更广泛推广作用。

Comparison between amplatzer septal occluder and surgical closure of secundum atrial septal defect

Objective:To compare the clinical effectiveness and safety of interventional closure using Amplatzer septal occluder(ASO) with surgical closure of secundum atrial septal defect(ASD).Methods:From May 1998to December 2001,72 patients who underwent transcatheter ASD closure using ASO and 66 patients who underwent surgical closure of ASD were involved in the study.The effectiveness and safety of both methods were compared.Results:The technical success rate was 97.2% (70/72) of the ASO group and 100% of the surgical group.The procedure time and the length of hospital stay of the ASO group were shorter than those of the surgical group.The complication rate of ASO group was lower than that of surgical group(7.1% and 22.7% ,P＜0.05).Blood products were adninistered to 89.1% patients in the surgical group,no patients in the ASO group required transfusion.The mean total cost of the ASO group was significantly higher than that of the surgical group.Conclusions:Transcatheter closure of ASD Ⅱ using ASO is an alternative to surgery within acceptable linits.The method would be applied broadly if the cost of ASO was reduced.