房间隔缺损介入治疗和外科手术的对比分析

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1、【摘要】　　目的：比较经导管封堵与外科手术治疗继发孔型房间缺损(ASD)的疗效、安全性和费用情况。方法：采用相同的入选标准,选择继发孔型ASD患者148人，其中介入治疗组82例，外科手术组66例。应用回顾性对比研究方法，比较两组的疗效、并症和费用情况。结果：介入治疗组和外科手术组的成功率分别为95.1%和100%(P=0.018),术后残分流率分别为3.5%和3.0%(P=0.833)。心律失常为最常见并发症，介入组低于外科组（14.6%∶31.8%，P<0.05）;介入组中无1例患者需要输血,外科组中全部患者需要输血（P<0.001）；介入组和外科组操作时间分别为（48±12.2）min和（

2、158±16.4）min（P<0.001）；介入组住院天数短于外科组［（6.0±2.0）d∶（13.0±3.0）d，P<0.01］。介入组和外科组治疗费用分别为（26729±1675）元和（22393±1739）元(P<0.05)。结论：外科手术较经导管封堵术成功率稍高、适应症广,但经导管封堵术却有手术时间短、并发症发生率低、创伤小、恢复快等优点。【关键词】心脏导管插入术　外科手术　房间隔缺损　　Contrastanalysisbetweentranscatheterandsurgicalclosuremethodsinpatientswithatrialseptaldefect/WUGuan

3、g

4、wei,LINYing

5、zhong,WANGMeng

6、jie，LUZhi

7、hong,ZHAOYi

8、lan,HUChang

9、xing//　　Abstract：Objective:Tocomparethesafety,efficacy,complicationsandcostbetweentranscatheterandsurgicalclosuremethodsinpatientswithatrialseptaldefect(ASD).Methods:Retrospectiveanalysiswasdoneon148patientswithsecondumatrialseptaldefect

10、s:66casesweretreatedsurgicallyand82casesweretreatedbytranscatheterclosure.Thesafety,efficacy,complicationsandcostbetweentwogroupswerecompared.Results:Theinstantproceduralsuccessratewas95.1%forthetranscatheterclosuregroupand100%forthesurgicalclosuregroup(P=0.018).Totalcomplicationratesbothofthetransc

11、atheterclosuregroupandthesurgicalclosuregroupwere18.3%and34.8%respectively(P<0.05),Bloodproductswereadministeredto36patientsinthesurgicalgroupandnopatientinthetranscatheterclosuregroup(P<0.01).Meanoperationtimebothofthetranscatheterclosuregroupandthesurgicalclosuregroupwas(48±12.2)minand(158±16.4)mi

12、n（P<0.001）；daysofstayinhospitalwere(6.0±2.0)daysintranscatheteroccludegroup,(13.0±3.0)daysinsurgerygrouprespectively.CostbothofthetranscatheterclosuregroupandthesurgicalclosuregroupwereRMB(26729±1675)andRMB(22393±1739)respectively(P<0.05).Conclusion:TranscatheterclosureofsecondumASDwithAmplatzersept

13、aloccluderisanefficient,non

14、surgical,andsafemethodalthoughitssuccessrateislower.　　Author′s　address：DepartmentofCardiology,ThePeople’sHospitalofGuangxi，Nanning，Guangxi，530021，China　　Keywords：Heartcathe