中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2009年
2期
96-98
,共3页
胡盛寿%李巅远%闫军%李守军%晏馥霞%李立环%魏以桢%郑哲%刘志刚%崔彬%陶天富
鬍盛壽%李巔遠%閆軍%李守軍%晏馥霞%李立環%魏以楨%鄭哲%劉誌剛%崔彬%陶天富
호성수%리전원%염군%리수군%안복하%리립배%위이정%정철%류지강%최빈%도천부
心脏缺损,先天性%房间隔缺损%心脏外科手术
心髒缺損,先天性%房間隔缺損%心髒外科手術
심장결손,선천성%방간격결손%심장외과수술
Heart defects Congenital Atrial septal defect Cardiac surgical procedures
目的 介绍一种房间隔缺损(ASD)"复合"技术介入封堵方法,并探讨该手术方法的优缺点.方法 2007年6月至2008年3月,27例婴幼儿房间隔缺损者接受新"复合"技术治疗.其中男15例,女12例.年龄3个月-4岁,平均(2.00±O.22)岁.采用浅镇静加局部麻醉,非气管插管单纯面罩吸氧或喉罩下辅助通气支持,胸骨旁第4肋间小切口,保留胸膜,经胸膜外进入心包腔显露右心房壁,切开右房壁置入ASD封堵器及输送器.心前区或剑突下超声引导进行ASD介入封堵术.结果 全部病儿3d后康复出院,随访0.5-9.5个月,平均(5.9±0.5)个月,仅l例病儿因心包压塞行心包穿刺引流术,余无异常.超声检查没有残余分流或其它并发症.结论 该手术方法创伤小、疗效好,费用低,是婴幼儿ASD病例一种较为理想手术方法.
目的 介紹一種房間隔缺損(ASD)"複閤"技術介入封堵方法,併探討該手術方法的優缺點.方法 2007年6月至2008年3月,27例嬰幼兒房間隔缺損者接受新"複閤"技術治療.其中男15例,女12例.年齡3箇月-4歲,平均(2.00±O.22)歲.採用淺鎮靜加跼部痳醉,非氣管插管單純麵罩吸氧或喉罩下輔助通氣支持,胸骨徬第4肋間小切口,保留胸膜,經胸膜外進入心包腔顯露右心房壁,切開右房壁置入ASD封堵器及輸送器.心前區或劍突下超聲引導進行ASD介入封堵術.結果 全部病兒3d後康複齣院,隨訪0.5-9.5箇月,平均(5.9±0.5)箇月,僅l例病兒因心包壓塞行心包穿刺引流術,餘無異常.超聲檢查沒有殘餘分流或其它併髮癥.結論 該手術方法創傷小、療效好,費用低,是嬰幼兒ASD病例一種較為理想手術方法.
목적 개소일충방간격결손(ASD)"복합"기술개입봉도방법,병탐토해수술방법적우결점.방법 2007년6월지2008년3월,27례영유인방간격결손자접수신"복합"기술치료.기중남15례,녀12례.년령3개월-4세,평균(2.00±O.22)세.채용천진정가국부마취,비기관삽관단순면조흡양혹후조하보조통기지지,흉골방제4륵간소절구,보류흉막,경흉막외진입심포강현로우심방벽,절개우방벽치입ASD봉도기급수송기.심전구혹검돌하초성인도진행ASD개입봉도술.결과 전부병인3d후강복출원,수방0.5-9.5개월,평균(5.9±0.5)개월,부l례병인인심포압새행심포천자인류술,여무이상.초성검사몰유잔여분류혹기타병발증.결론 해수술방법창상소、료효호,비용저,시영유인ASD병례일충교위이상수술방법.
Objeelive To describe a new hybrid procedure for closure of a atrial septal defect(ASD).The aim of our study was to demonstratethe conceptual develolm,and the feasibility of a hybrid approachto closure of ASD.Methods June 2007 to March 2008,27 ASD infant patients(15 male,12 female)underwent a new hybrid procedure treatment in FuWai Hospital .The age of patients from 3 months to 4-year-old[mean age (2.00 4-O.22)years old].On the condition of conscious analgesia/sedation with remifentanil and propofol (while local anesthesia with ropivaeaine),the patients keep spontaneous spontaneous respiration by facemask or laryngeal airway mask with 40%-60%oxygen and 1%-2%sevoflurane.A minimal right parasternal incision through the fourth intercostals space was ueed to cut open the fourth intercostals muscle to pericardial cavity.Keeping pleural membrame integrity and through ectal pleural membrane access,right atrium was be exposed.The atrial septal occluder device and delivery system was being sent into right atrium througa right airiumincision.The atrial septal occluder was deployed and evaluated under intraoperative precordium or xiphoid process echocardiography guidance.Results All infant patients recovered unevertfully and discharged from hospital three days after opera-tion.Patient follow-up occurred from 0.5 to 9.5months [mean of (5.9±0.5)months].All patients were free of symptoms and post-operation complications during follow-up,only one patient was been paracentsis pericardii for pericardial tamponade.Conclusion This new hybrid procedure is effective and safe.The cost of this new procedure is lower than other treatments.It is an ideal treatment to infant atrial septal defect patients.
