【摘要】：目的:經(jīng)傾向得分匹配法(PSM)均衡組間基線后,對(duì)比經(jīng)靜脈導(dǎo)管封堵術(shù)(TVDC)與經(jīng)胸導(dǎo)管封堵術(shù)(TTDC)治療室間隔缺損(VSD)的成功率、并發(fā)癥及住院費(fèi)用等情況,為臨床個(gè)體化選擇提供依據(jù)。方法:選擇2012年1月至2014年9月入住我院的VSD行TVDC者81例、行TTDC者263例。以81例行TVDC者為基礎(chǔ)(TVDC組),根據(jù)年齡、體重和VSD直徑進(jìn)行傾向得分匹配。按1:2配比,得到符合配比條件、同期行TTDC患者162例(TTDC組)。通過(guò)收集其基線特征、手術(shù)情況、術(shù)前及術(shù)后檢查及隨訪情況等資料,比較兩種術(shù)式成功率、并發(fā)癥(嚴(yán)重及一般并發(fā)癥)、費(fèi)用及住院天數(shù)等情況。結(jié)果:經(jīng)1:2配比后兩組基線資料無(wú)明顯差異。配比后兩組間封堵器直徑(6.2±1.93 mm vs 6.64±1.96 mm,p=0.139)、手術(shù)成功率(95.1%vs 97.5%,p=0.525)及嚴(yán)重并發(fā)癥發(fā)生率(0.0%vs 2.5%,p=0.304)均無(wú)明顯差別,兩組均無(wú)死亡病例。TTDC組一般并發(fā)癥的發(fā)生率較TVDC組高(61.7%vs 46.9%,p=0.028)。在隨訪過(guò)程中,兩組無(wú)嚴(yán)重并發(fā)癥生存率無(wú)明顯差異(Log-Rank檢驗(yàn):p=0.127),TVDC組無(wú)一般并發(fā)癥生存率高于TTDC組(Log-Rank檢驗(yàn):p=0.004)。此外,TVDC組在住院時(shí)間(7.53±1.51天vs 11.09±4.03天,p0.001)、住院總費(fèi)用(30123.71±6021.39元vs 37269.77±7749.02元,p=0.011)及全麻率(64.2%vs 100%,p0.001)方面均優(yōu)于TTDC組。結(jié)論:TVDC和TTDC均可成功封堵VSD,前者在手術(shù)創(chuàng)傷、住院總費(fèi)用、康復(fù)及美觀等方面均優(yōu)于后者。同時(shí)符合兩種術(shù)式適應(yīng)證的VSD患者,更建議行TVDC。
[Abstract]:Objective: to compare the success rate, complication and hospitalization cost of transvenous catheter closure (TVDC) and transthoracic catheter occlusion (TTDC) in the treatment of ventricular septal defect (VSD) after the baseline between the (PSM) equalization group with propensity score matching. To provide the basis for clinical individualized selection. Methods: 81 cases of VSD and 263 cases of TTDC were selected from January 2012 to September 2014. Based on 81 patients with TVDC (TVDC group), tendency scores were matched according to age, body weight and VSD diameter. According to the 1:2 ratio, the matching conditions were obtained. 162 cases of TTDC were given at the same time (TTDC group). By collecting the baseline features, surgical conditions, preoperative and postoperative examinations and follow-up data, the success rate, complications (severe and general complications), cost and length of stay of the two operations were compared. Results: there was no significant difference in baseline data between the two groups after 1:2 matching. There was no significant difference in occluder diameter (6.2 鹵1.93 mm vs 6.64 鹵1.96 mm,p=0.139), successful rate of operation (95.1%vs 97.5) and serious complication rate (0.0%vs 2.5 and p0.304) between the two groups after matching. The incidence of general complications in TTDC group was higher than that in TVDC group (61.7%vs 46.9 p0.028). During the follow-up, there was no significant difference between the two groups in the survival rate without serious complications (Log-Rank test: the survival rate of no complication in the group of 0.127), TVDC was higher than that in the group of TTDC (Log-Rank test: p0. 004). In addition, TVDC group was superior to TTDC group in terms of hospitalization time (7.53 鹵1.51 days, vs 11.09 鹵4.03 days, p0.001), total hospitalization cost (30123.71 鹵6021.39 vs 37269.77 鹵7749.02 yuan, p0.011) and general anesthesia rate (64.2%vs 100g / p0.001). Conclusion: both TVDC and TTDC are superior to VSD, in surgical trauma, total hospitalization cost, rehabilitation and beauty. It is recommended that TVDC. should be performed in patients with VSD who meet the indication of two kinds of operation at the same time.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R541.1

【共引文獻(xiàn)】

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本文編號(hào)：2279013