CAJ | 학술논문

目的：探讨经胸微创封堵术治疗室间隔缺损的围术期处理措施，以促进患儿快速康复。方法2012年5月至2013年6月，我们收治年龄6个月至3岁的单纯室间隔缺损患儿95例，其中经胸超声筛查后行经胸微创封堵术37例，采用传统外科体外循环手术58例，分析两组患儿术后早期并发症及处理措施，并对两组患儿的年龄、性别、体重、NYHA心功能分级、住院天数、手术时间、ICU监护时间、输血量、引流量及早期并发症等进行比较。结果两组年龄、体重、性别、心功能比较，差异无统计学意义，而经胸微创封堵术治疗与传统外科手术治疗比较，住院天数、手术时间、ICU监护时间更短，输血量、引流量更少，差异均有统计学意义，两组术后早期并发症的发生率相当，经积极干预后短期内恢复。结论经胸微创封堵术操作简单，术后恢复快，是治疗室间隔缺损的理想手段。术前食管超声再次评估、术后适当镇痛、镇静及心功能支持可减少术后早期并发症的发生，促进患儿快速康复。
목적：탐토경흉미창봉도술치료실간격결손적위술기처리조시，이촉진환인쾌속강복。방법2012년5월지2013년6월，아문수치년령6개월지3세적단순실간격결손환인95례，기중경흉초성사사후행경흉미창봉도술37례，채용전통외과체외순배수술58례，분석량조환인술후조기병발증급처리조시，병대량조환인적년령、성별、체중、NYHA심공능분급、주원천수、수술시간、ICU감호시간、수혈량、인류량급조기병발증등진행비교。결과량조년령、체중、성별、심공능비교，차이무통계학의의，이경흉미창봉도술치료여전통외과수술치료비교，주원천수、수술시간、ICU감호시간경단，수혈량、인류량경소，차이균유통계학의의，량조술후조기병발증적발생솔상당，경적겁간예후단기내회복。결론경흉미창봉도술조작간단，술후회복쾌，시치료실간격결손적이상수단。술전식관초성재차평고、술후괄당진통、진정급심공능지지가감소술후조기병발증적발생，촉진환인쾌속강복。
Objetive To investgate perioperative management of ventricular septal defect treatment via one-stop hybrid procedures,and speed up the recovery process of the patients. Methods The postoperative management and intensive care data of 37 ventricular septal defect patients via one-stop hybrid procedures were retrospectively analyzed and compared with 58 ventricular septal defect patients via traditional surgical proce-dures in the same period.From May,2012 to June,2013,95 patients of ventricular septal defect aged 6 months to 3 years old were treated in our department,and with a transthoracic echocadiography screening were divided into one-stop hybrid procedure group(n=37)and traditional surgical procedure (n=58).Early postoperative complications and management were retrospectively analyzed,and age,gender,weight,cardiac function,hos-pital day,postoperative mechanical ventilator time,operation time,ICU hospital time,blood transfusion a-mount,drainage amount and incidence of early postoperative complications between two groups were compared. Results Age,gender,weight and cardiac function had no difference between two groups,but hospital day,op-eration time and ICU hospital time was shorter,blood transfusion amount and drainage amount was fewer in one-stop hybrid procedure group than traditional surgical procedure.Incidence of early postoperative complica-tions between two groups were almost equal,and the patients could both recover from the complications in a short time after positive interventions. Conclusion One-stop hybrid procedure was simple,made a quick re-covery after operation and was an ideal method for ventricular septal defect treatment.Proper postoperative an-algesia,enough cardiac function support and a preoperative evaluation by transesophageal echocadiography could reduce the incidence of early postoperative complications and speed up the recovery process of patients.