Department of Anesthesiology, Lanzhou University Second Hospital, Lanzhou 730030, China.
Comput Math Methods Med. 2022 Jul 14;2022:2969979. doi: 10.1155/2022/2969979. eCollection 2022.
To investigate the efficacy of minimally invasive transcatheter closure of congenital heart disease (CHD) under the guidance of transesophageal ultrasound.
A total of 100 patients with CHD treated in our hospital from February 2019 to April 2020 were enrolled in the group. The patients were randomly divided into control group and research group. The control group received minimally invasive transcatheter closure under the guidance of X-ray, and the research group received minimally invasive transcatheter closure under the guidance of transesophageal ultrasound. The operative results, the intraoperative- and postoperative-related indexes, and the incidence of early postoperative complications and follow-up results were compared.
First of all, we compared the results of the two groups: 48 cases of success, 2 cases of difficulty in the research group, 35 cases of success, 11 cases of difficulty, and 4 cases of failure in the control group. The success rate in the research group was higher than that in the control group ( < 0.05). Secondly, we compare the relevant indicators in the process of operation. The operation time, cardiopulmonary bypass time, upper and lower cavity obstruction time, and blood transfusion volume in the research group were lower than those in the control group ( < 0.05). In terms of postoperative-related indexes, the ventilator-assisted time, 24 h postoperative drainage, ICU time, and postoperative hospital stay in the research group were all lower than those in the control group ( < 0.05). The incidence of early postoperative complications in the research group was significantly lower than that in the control group such as secondary pleural hemostasis, pulmonary infection, pleural effusion, subcutaneous emphysema, poor incision healing, phrenic nerve loss, and right lower limb numbness ( < 0.05). All patients were followed up for 6 months, and the cardiac function of both groups returned to normal. There was no significant difference in the incidence of postoperative residual shunt and new tricuspid regurgitation. There was no significant difference in the data ( > 0.05). Considering abnormal ECG events, the incidence of abnormal ECG events (complete right bundle branch block, incomplete right bundle branch block, second- and third-degree block, left anterior branch block) in the research group was significantly lower than that in the control group ( < 0.05).
Minimally invasive transcatheter closure of CHD under the guidance of transesophageal ultrasound has the advantages of less trauma, less blood loss, short hospital stay, simple operation, less postoperative complications, and remarkable therapeutic effect. Minimally invasive transcatheter closure under the guidance of transesophageal ultrasound has the advantage of adapting to a wide range of syndromes and can be used for the closure of CHD in children. According to different types of CHD, registering the corresponding occlusive pathway can improve the success rate of operation. Through postoperative reexamination and regular follow-up, it is proved that minimally invasive transcatheter closure under the guidance of transesophageal ultrasound is safe, effective, and feasible.
探讨经食管超声心动图引导下微创介入封堵先天性心脏病（CHD）的疗效。
选取 2019 年 2 月至 2020 年 4 月我院收治的 100 例 CHD 患者为研究对象，采用随机数字表法将患者分为对照组和研究组，每组 50 例。对照组患者采用 X 线引导下微创介入封堵，研究组患者采用经食管超声心动图引导下微创介入封堵。比较两组患者的手术效果、术中及术后相关指标及早期术后并发症发生率和随访结果。
首先，比较两组患者的结果：研究组有 48 例手术成功，2 例困难，对照组有 35 例手术成功，11 例困难，4 例失败。研究组成功率高于对照组（<0.05）。其次，比较手术过程中的相关指标。研究组的手术时间、体外循环时间、上下腔梗阻时间、输血量均低于对照组（<0.05）。在术后相关指标方面，研究组的呼吸机辅助时间、24 h 术后引流量、入住 ICU 时间和术后住院时间均低于对照组（<0.05）。研究组的早期术后并发症发生率明显低于对照组，如二次胸腔止血、肺部感染、胸腔积液、皮下气肿、切口愈合不良、膈神经损伤和右下肢麻木（<0.05）。所有患者均随访 6 个月，两组患者的心功能均恢复正常，术后残余分流和新三尖瓣反流发生率无明显差异（>0.05）。考虑异常心电图事件，研究组异常心电图事件（完全性右束支传导阻滞、不完全性右束支传导阻滞、二度和三度阻滞、左前分支阻滞）发生率明显低于对照组（<0.05）。
经食管超声心动图引导下微创介入封堵 CHD 具有创伤小、失血少、住院时间短、操作简单、术后并发症少、疗效显著等优点。经食管超声心动图引导下微创介入封堵术适应范围广，可用于儿童 CHD 的封堵。根据不同类型的 CHD，记录相应的闭塞途径可以提高手术成功率。通过术后复查和定期随访，证明经食管超声心动图引导下微创介入封堵术是安全、有效、可行的。
