目的对比分析两种治疗简单先天性心脏病的手术方式,探讨治疗简单先天性心脏病的最佳术式,为临床手术方式的选择提供参考。方法 208例简单先天性心脏病患者,随机分为对照组(105例)和观察组(103例)。对照组行传统体外循环直视修补术,观察组行经食道超声引导下经胸壁微创封堵术。比较两组患者的住院时间、手术时间、术中失血量、住院费用、并发症指标。结果观察组住院时间、手术时间分别为(8.25±2.31)d、(71.53±10.82)h,显著短于对照组的(13.28±2.50)d、(209.00±22.07)h,两组比较,差异具有统计学意义(P<0.05);观察组术中失血量为(54.68±41.26)ml,少于对照组的(568.10±85.80)ml,两组比较,差异具有统计学意义(P<0.05);观察组住院费用为(30882±3318)元,对照组为(30084±5246)元,两组比较差异无统计学意义(P>0.05);观察组并发症发生率为4.85%,少于对照组的13.33%,两组比较,差异具有统计学意义(P<0.05)。结论两种治疗方式术后疗效均良好且具有并发症低等优势,但体外循环直视修补手术患者住院时间长及术后恢复较慢,食道超声引导经胸壁微创封堵术住院时间短、恢复快及创伤小。但两种治疗方式具有一定的互补性,而且部分患者因特殊情况只能依靠体外循环直视下修补完成,直视修补术后残余漏也可行封堵治疗,封堵治疗需要体外循环作为根本保障。 Objective To compare and analyze the two surgical methods for the treatment of simple congenital heart disease and to explore the best surgical method for the treatment of simple congenital heart disease and to provide a reference for the selection of clinical surgical methods. Methods 208 patients with simple congenital heart disease were randomly divided into control group (105 cases) and observation group (103 cases). The control group underwent open-circuit repair by traditional cardiopulmonary bypass. The observation group underwent minimally invasive transcatheter closure of the thoracic wall guided by transesophageal echocardiography. The length of hospital stay, operation time, intraoperative blood loss, hospitalization costs and complications were compared between the two groups. Results The length of hospital stay and operation time in the observation group were (8.25 ± 2.31) d and (71.53 ± 10.82) h, respectively, which were significantly shorter than those in the control group (13.28 ± 2.50 and 196.00 ± 22.07) h (54.68 ± 41.26) ml, less than the control group (568.10 ± 85.80) ml, the difference between the two groups was statistically significant (P <0.05); The cost of hospitalization was (30882 ± 3318) yuan in the observation group and (30084 ± 5246) yuan in the control group, with no significant difference between the two groups (P> 0.05). The complication rate in the observation group was 4.85% (13.33%). There was significant difference between the two groups (P <0.05). Conclusion Both of the two treatment methods have good postoperative curative effect and low complication rate. However, patients who underwent open-circuit cardiopulmonary bypass surgery have a long hospital stay and postoperative recovery. The esophageal sonographic guided minimally invasive closure through the chest wall has a short hospital stay, Fast recovery and less trauma. However, the two treatment methods have a certain degree of complementarity, and some patients due to special circumstances can only rely on cardiopulmonary bypass under direct vision to complete the repair, direct repair of residual leakage may be feasible after the closure of treatment, closure therapy requires cardiopulmonary bypass as a fundamental guarantee .