室间隔缺损介入封堵和外科手术对瓣膜功能影响的对比研究

目的:通过对介入封堵治疗的室间隔缺损患者进行中长期临床随访,并和同期行外科修补手术的室间隔缺损患者进行对比,分析两种术式对心脏瓣膜功能的影响。方法:选择行介入封堵治疗患者279例(介入组),行外科手术修补治疗患者243例(手术组)。利用超声心动图检查瓣膜反流发生情况及随访转归情况,并对两组瓣膜反流的发生率进行对比研究。结果:术后短期介入组二尖瓣反流发生率较手术组高(P0.05),三尖瓣和主动脉瓣反流发生率两组相比无统计学差异。中长期随访中,三尖瓣反流、主动脉瓣反流以及二尖瓣反流两组相比均无统计学差异。结论:室间隔缺损介入封堵治疗疗效确切,安全性高,创伤较小。术前利用超声心动图对患者的严格筛选,术中熟练轻柔稳定的操作和适合封堵器的选择是减少介入封堵术后发生瓣膜反流最重要的因素。

Comparative Study of Transcatheter and Surgery for Valvular Function of Ventricular Septal Defects

Objective:By comparing the patients who was accepted transcatheter closure to the patients who was treated by surgical repair, and analyze the occurrence and outcome of the valvular regurgitation by the intermediate and long-term clinical follow-up.Methods:279 patients were treated catheter occluder (Intervention group) and 243 patients were treated with surgery (Surgery group). The diagnosis of valvular regurgitation by transthoracic echocardiography after operation and intermediate and long-term follow-up are compared between the two groups.Results:The incidence of mitral regurgitation in intervention group was higher than surgery group (P<0.05), tricuspid regurgitation and aortic regurgitation were no significant difference between the two groups in the short-term postoperative. Long-term follow-up, tricuspid regurgitation, aortic regurgitation and mitral regurgitation were no significant difference between the two groups.Conclusion:The treatment of transcatheter closure of ventricular septal defect was effective, safety and less trauma. Patients should select strictly by using echocardiography before treatment, skilled and stable operation during the treatment, and choosing suitable occluder were the most important factors to reduce the incidence of valvular regurgitation.