摘要
目的应用新的连续缝合技术修补膜周大室间隔缺损（VSD），并与传统方法进行对比研究。方法手术治疗321例膜周大VSD，根据手术方式的不同分为三组：A组70例采用间断缝合法修补；B组116例采用传统连续缝合法修补；C组135例采用新的连续缝合技术修补。结果转机时间和阻断时间c组最短，分别为（48±36）min和（26±18）min；残余分流在C组无一例发生，发生率均较其他两组低（P〈0．05）；各组均无第三度房室传导阻滞（AVB）发生，但都有第二度AVB，C组为0．7％（1／135），低于A组的4．3％（3／70）（P〈0．05），与B组的0．9％（1／116）比较差异无统计学意义，随访1-3年均恢复为正常窦性心律；完全性右束支传导阻滞三组发生率差异无统计学意义；三尖瓣关闭不全A组为8．5％（6/70），高于其他两组（P〈0．05）。结论新的连续缝合法能减少手术阻断及转机时间、减少心内异物存留、简化手术原则及操作技术，减少了残余分流发生、不增加传导阻滞的发生。
Objective To compare the effect of repairing large perimembranous ventricular septal defect （VSD） with a new continuous stitching and two classical methods. Methods From January 2005 to January 2008,321 cases with VSD were operated. All the cases were divided into 3 groups according to operational way, with discontinuous stitching in group A （70 cases）, continuous stitching in group B （116 cases）,new continuous stitching in group C （ 135 cases）. All the patients were total corrected with hypothermic cardiopulmonary bypass. Results Group C had the shortest cardiopulmonary bypass and aortic cross-clamp times [ （48 ±36） min and （26 ± 18） min ] among the three groups （P 〈 0.05）. Group C had not residual shunt and incidence rate was lowest among the three groups （P 〈 0.05 ）. Temporary second degree auriculoventricular bolck （AVB） was found in the early stage and no third degree AVB among the three groups. Tricuspid regurgitation was higher in group A, but there was no significant difference between group B and group C. Follow-up was completed in a duration of 1-3 years and all the cases had a good health after discharged. Conclusions The new continuous stitching method has short cardiopulmonary bypass and aortic cross-clamp times. It has fewer residual shunt than other two classical methods and has no evidence of higher AVB occurrence.
出处
《中国医师进修杂志》
2010年第5期29-31,共3页
Chinese Journal of Postgraduates of Medicine
关键词
心脏病
室间隔缺损
心脏外科手术
治疗结果
Heart diseases
Heart septal defect ventricular
Cardiac surgical procedures
Treatment outcome
