单纯继发孔房间隔缺损导管介入封堵与外科微创封堵的比较

目的比较外科微创封堵术与经导管介入封堵治疗房间隔缺损的临床特征,为房间隔缺损患者选择治疗方法。方法回顾性分析2009年7月至2010年6月在我院接受介入治疗的房间隔缺损病例321例,其中行外科微创封堵154例(组A),行导管介入封堵治疗167例(组B)。结果组A手术成功率98.7%,手术时间(61.45±23.57)min,术后住院时间(5.06±2.01)d,并发症发生率20.1%,住院费用(2.94±0.42)万元。组B手术成功率98.8%,手术时间(25.28±10.56)min,术后住院时间(3.41±0.70)d,并发症发生率3.0%,住院费用(2.11±0.32)万元。随访3～12个月,无死亡病例。结论两种治疗方法均可有效地治疗单纯房间隔缺损,均有较高的成功率,外科微创封堵适应证广泛,无X线辐射,操作简单,易于推广;介入治疗住院时间短,创伤小,并发症少,住院费用低,有好的临床应用前景。

Comparison study between mini-invasive surgery and transcatheter closure of secundum atrial septal defect

Objective To select the better treatment for atrial septal defect by comparing mini-invasive surgery and transcatheter closure.Methods 321 patients were enrolled in this study.154 patients were treated by mini-invasive surgery(group A),and 167 patients were treated by tranacatheter closure(group B).Results The success rate of group A was 98.7%.Operation time was(61.45±23.57)min.Hospital stay after operation was(5.06±2.01)d.The incidence of postoperative complications was 20.1%.Cost of hospitalization was(29.4±4.2) thousand yuans.The success rate of group B was 98.8%.Operation time was(25.28±10.56) min.Hospital stay after operation was(3.41±0.70)d.The incidence of complications was 3.0%.Cost of hospitalization was(21.1±3.2) thousand yuans.All cases were followed-up for an average of 10.1 months(range.3-12 months) and no patient died during this period.Conclusions Both ways were ripe for simple secundun atrial septal defect and each had its specified dominance.The mini-invasive surgery is superior than transcatheter closure in terms of wide indications,simplicity,radiation damage,but transcatheter closure had a shorter time to be in hospital and had the adventage of smaller wound a,less complications and less cost of hospitalization.