先天性心脏病介入治疗与外科治疗临床比较

目的:对房间隔缺损(ASD)、室间隔缺损(VSD)的介入治疗(Amplatzer封堵器)和外科手术治疗的临床疗效进行比较。方法:2004年5月至12月住院患儿,符合单一左向右分流畸形ASD或VSD,根据治疗方法不同分为介入组和手术组;比较2组在疗效、费用、并发症、输血量及住院时间等方面的异同;通过放免法测定2组治疗前后的心钠素(ANP)水平。结果:2组手术成功率均为100%;介入组均未输血,手术组均输血治疗(P<0·01);术后住院时间介入组少于手术组(P<0·01);治疗费用介入组高于手术组(P<0·01);ANP水平、外科手术及介入治疗后均较治疗前降低。结论:单一ASD、VSD的介入治疗与手术治疗临床效果相同;介入组不需输血,术后住院时间短,但治疗费用较昂贵。

Comparative study on the congenital heart disease between intervention and surgical procedures

Objective:To compare the clinical efficiency of interventional procedure and surgical repair of atrial septal defect (ASD) and ventricle septal defect (VSD).Method:From May 2004 to December 2004,the patients in our department with ASD or VSD,without associated structural cardiac anomalies, all the patients were divided into two groups: interventional group and surgical group;Results、complications、cost 、hospital stay and transfusion between the two groups were compared; Atrial natriuretic peptide (ANP) were measured before and after treatment by collect venous blood.Result:The technical success rates of both groups were 100%,blood product were administered to all the patients in surgical group, no patients in interventional group required;Hospital stay after operation in surgical group was 7.5±1.2 days versus 5.1±1.3 days in interventional group (P<0.01) ;The mean cost of the interventional procedure was$ 45235 ± 10204 as compared with$ 21010 ± 1907 for surgery (P<0.01); The patients with ASD or VSD had significantly higher ANP values and it decreased after treatment in both groups.Conclusion:The efficiency is similar between the interventional procedure and surgical repair for ASD and VSD;There is the shorter hospital stay, higher cost and no transfusion in the interventional procedure compared with surgical repair.