本文選題：室間隔缺損 + 經(jīng)皮導管介入封堵術��； 參考：《福建醫(yī)科大學》2015年碩士論文

【摘要】：目的:對經(jīng)皮導管介入封堵術、經(jīng)胸微創(chuàng)封堵術和直視修補術3種治療室間隔缺損的手術方式對心臟瓣膜功能的影響進行回顧性對比分析,以助于室間隔缺損手術方式的合理化選擇。方法:選用2013年1月-2015年1月,在福建醫(yī)科大學附屬協(xié)和醫(yī)院心臟外科及心臟內(nèi)科住院行手術治療的單純室間隔缺損患者263例,其中經(jīng)胸微創(chuàng)封堵組(微創(chuàng)組)79例,經(jīng)皮導管介入封堵術組(介入組)36例,直視修補術組(修補組)148例;對微創(chuàng)組、介入組及修補組在術后1周及3個月對三尖瓣關閉不全、三尖瓣狹窄及主動脈瓣關閉不全的發(fā)生率進行對比研究。兩組間率的比較采用卡方檢驗。結果:在術后l周,介入組及微創(chuàng)組主動脈瓣關閉不全、三尖瓣關閉不全的發(fā)生率較修補組高(P0.05)。術后3個月,微創(chuàng)組、介入組及修補組的發(fā)生率差異無統(tǒng)計學意義(P0.05)。術后1周及3個月,微創(chuàng)組與修補組、介入組分別比較,三尖瓣狹窄的發(fā)生率差異無統(tǒng)計學意義(P0.05)。結論:經(jīng)皮導管介入封堵術、經(jīng)胸微創(chuàng)封堵術和直視修補術3種手術方式治療對心臟瓣膜功能影響均較輕。應充分評估病情,嚴格掌握手術指證,選擇合適的手術方式,避免粗暴動作,行封堵術時選擇合適大小的封堵器,減少對瓣膜的影響。
[Abstract]:Objective: to compare and compare the effects of percutaneous catheter closure, transthoracic minimally invasive closure and open vision repair on the function of cardiac valve in patients with ventricular septal defect (VSD). Objective: to help the rational choice of the operation mode of ventricular septal defect (VSD). Methods: from January 2013 to January 2015, 263 cases of simple ventricular septal defect (VSD) were operated in the Department of Cardiac surgery and Cardiology, affiliated to Union Hospital of Fujian Medical University, including 79 cases in the minimally invasive transthoracic closure group (79 cases in the minimally invasive group). Percutaneous catheter closure was performed in 36 cases in the interventional group and 148 cases in the open vision repair group, and tricuspid insufficiency in the minimally invasive group, interventional group and repair group at 1 week and 3 months after operation. The incidence of tricuspid stenosis and aortic insufficiency was compared. The rates of the two groups were compared by chi-square test. Results: at 1 week after operation, the incidence of aortic insufficiency and tricuspid insufficiency in interventional group and minimally invasive group was higher than that in repair group (P 0.05). 3 months after operation, there was no significant difference in the incidence rate between the minimally invasive group, interventional group and repair group (P 0.05). 1 week and 3 months after operation, the incidence of tricuspid stenosis in the minimally invasive group was not significantly different from that in the repair group and interventional group (P 0.05). Conclusion: percutaneous catheter closure, transthoracic minimally invasive closure and open vision repair have slight effects on heart valve function. It is necessary to evaluate the condition of the disease strictly master the operation indication select the appropriate operation method avoid rough action and select the appropriate size occluder to reduce the influence on the valve.
【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R654.2

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