發(fā)布時(shí)間：2018-05-21 10:56

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

【摘要】：目的:對經(jīng)皮導(dǎo)管介入封堵術(shù)、經(jīng)胸微創(chuàng)封堵術(shù)和直視修補(bǔ)術(shù)3種治療室間隔缺損的手術(shù)方式對心臟瓣膜功能的影響進(jìn)行回顧性對比分析,以助于室間隔缺損手術(shù)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(xué)附屬協(xié)和醫(yī)院心臟外科及心臟內(nèi)科住院行手術(shù)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(dǎo)管介入封堵術(shù)組(介入組)36例,直視修補(bǔ)術(shù)組(修補(bǔ)組)148例;對微創(chuàng)組、介入組及修補(bǔ)組在術(shù)后1周及3個(gè)月對三尖瓣關(guān)閉不全、三尖瓣狹窄及主動(dòng)脈瓣關(guān)閉不全的發(fā)生率進(jìn)行對比研究。兩組間率的比較采用卡方檢驗(yàn)。結(jié)果:在術(shù)后l周,介入組及微創(chuàng)組主動(dòng)脈瓣關(guān)閉不全、三尖瓣關(guān)閉不全的發(fā)生率較修補(bǔ)組高(P0.05)。術(shù)后3個(gè)月,微創(chuàng)組、介入組及修補(bǔ)組的發(fā)生率差異無統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后1周及3個(gè)月,微創(chuàng)組與修補(bǔ)組、介入組分別比較,三尖瓣狹窄的發(fā)生率差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:經(jīng)皮導(dǎo)管介入封堵術(shù)、經(jīng)胸微創(chuàng)封堵術(shù)和直視修補(bǔ)術(shù)3種手術(shù)方式治療對心臟瓣膜功能影響均較輕。應(yīng)充分評估病情,嚴(yán)格掌握手術(shù)指證,選擇合適的手術(shù)方式,避免粗暴動(dòng)作,行封堵術(shù)時(shí)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(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R654.2

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