中国医药
中國醫藥
중국의약
CHINA MEDICINE
2011年
1期
28-29
,共2页
心室间隔缺损%微创手术%非体外循环%食道超声心动图%学习曲线
心室間隔缺損%微創手術%非體外循環%食道超聲心動圖%學習麯線
심실간격결손%미창수술%비체외순배%식도초성심동도%학습곡선
Ventricular septal defects%Minimally invasive%Non-cardiopulmonary bypass Device%Transesophageal echocardiography%Learning curve
目的 通过评估食管超声(TEE)引导下经胸微创封堵治疗心室间隔缺损(VSD)不同阶段的手术效果,探讨该技术的学习曲线.方法 回顾性分析2007年4月至2008年10月由同一手术组连续完成的60例TEE引导下经胸微创封堵治疗VSD患者的病历资料.按手术时间先后顺序依次分为4组(A、B、C、D组),每组15例,比较各组手术时间、术中出血量、中转开胸率、手术并发症以及术后住院时间,分析不同阶段的手术效果.结果 各组平均年龄、性别、体重及VSD类型等差异均无统计学意义(P＞0.05).A、B、C、D组手术时间分别为(29.6±9.6)、(27.4±9.2)、(20.0±8.2)和(17.1±7.2)min,A组和B组均明显长于C组和D组(均P＜0.01),而C组和D组之间差异无统计学意义(P=0.366);A、B、C、D组术中出血量[(59.7±13.4)m1],明显多于C组[(40.3±7.4)ml和(36.3±8.9)ml],A组和B组均明显多于C组和D组(P＜0.01),而C组和D组之间差异无统计学意义(P=0.287);手术并发症、中转开胸率以及术后住院时间比较,差异均无统计学意义(P＞0.05).结论 经胸微创封堵治疗VSD的学习曲线大约为30例.
目的 通過評估食管超聲(TEE)引導下經胸微創封堵治療心室間隔缺損(VSD)不同階段的手術效果,探討該技術的學習麯線.方法 迴顧性分析2007年4月至2008年10月由同一手術組連續完成的60例TEE引導下經胸微創封堵治療VSD患者的病歷資料.按手術時間先後順序依次分為4組(A、B、C、D組),每組15例,比較各組手術時間、術中齣血量、中轉開胸率、手術併髮癥以及術後住院時間,分析不同階段的手術效果.結果 各組平均年齡、性彆、體重及VSD類型等差異均無統計學意義(P＞0.05).A、B、C、D組手術時間分彆為(29.6±9.6)、(27.4±9.2)、(20.0±8.2)和(17.1±7.2)min,A組和B組均明顯長于C組和D組(均P＜0.01),而C組和D組之間差異無統計學意義(P=0.366);A、B、C、D組術中齣血量[(59.7±13.4)m1],明顯多于C組[(40.3±7.4)ml和(36.3±8.9)ml],A組和B組均明顯多于C組和D組(P＜0.01),而C組和D組之間差異無統計學意義(P=0.287);手術併髮癥、中轉開胸率以及術後住院時間比較,差異均無統計學意義(P＞0.05).結論 經胸微創封堵治療VSD的學習麯線大約為30例.
목적 통과평고식관초성(TEE)인도하경흉미창봉도치료심실간격결손(VSD)불동계단적수술효과,탐토해기술적학습곡선.방법 회고성분석2007년4월지2008년10월유동일수술조련속완성적60례TEE인도하경흉미창봉도치료VSD환자적병력자료.안수술시간선후순서의차분위4조(A、B、C、D조),매조15례,비교각조수술시간、술중출혈량、중전개흉솔、수술병발증이급술후주원시간,분석불동계단적수술효과.결과 각조평균년령、성별、체중급VSD류형등차이균무통계학의의(P＞0.05).A、B、C、D조수술시간분별위(29.6±9.6)、(27.4±9.2)、(20.0±8.2)화(17.1±7.2)min,A조화B조균명현장우C조화D조(균P＜0.01),이C조화D조지간차이무통계학의의(P=0.366);A、B、C、D조술중출혈량[(59.7±13.4)m1],명현다우C조[(40.3±7.4)ml화(36.3±8.9)ml],A조화B조균명현다우C조화D조(P＜0.01),이C조화D조지간차이무통계학의의(P=0.287);수술병발증、중전개흉솔이급술후주원시간비교,차이균무통계학의의(P＞0.05).결론 경흉미창봉도치료VSD적학습곡선대약위30례.
Objective To evaluate the clinical results of minimally invasive transthoracic device closure of ventricular septal defect (VSD) without cardiopulmonary bypass (CPB) under transesophageal echocardiography (TEE) guidance and to analyze the learning curve of this kind of operation. Methods Clinical data of a consecutive series of 60 VSD patients from April 2007 to October 2008 were reviewed. The patients were divided equally into 4 groups ( group A, B, C, D, n = 15 in each group). The operative time, quantity of bleeding, ratio of converting to intracardiac repair, complications and hospital stay were compared among the 4 groups. Results There was no difference among the 4 groups in terms of age, gender, body weight and the type of VSDs ( P ＞ 0.05). While the operative time in group A (29.6 ± 9.6) min and group B (27.4 ± 9.2) min were significantlylonger than that in group C (20.0 ± 8.2 min, P ＜ 0.01 ) and group D ( 17.1 ± 7.2 min, P ＜ 0. 01 ), there was no difference between group C and D (P=0.366). The quantity of bleeding in group A (59.7 ± 13.4)ml and group B (54.3 ±9.9)ml were more than that in group C (40.3 ± 7.4ml, P ＜ 0. 001 ) and group D ( 36.3 ± 8.9 ml, P ＜ 0. 001 ), but no difference was shown between group C and D ( P= 0.366). No difference was shown regarding complications, ratio of converting to intracardiac repair, and hospital stay between the 4 groups. Conclusion The learning curve of minimally invasive transthoracic device closure of VSD without CPB under TEE guidance is approximately 30 cases.
