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目的比较漂导丝法和去头猪尾管过室间隔法在室间隔膜部缺损介入封堵治疗中的优缺点。方法回顾分析2014年2月至2015年4月在四川大学华西第二医院行膜周部室间隔缺损介入封堵治疗的患者,以术中去头猪尾管过室间隔法建立轨道者为A组,术中使用漂导丝法建立轨道者为B组。比较两种方式的放射曝光时间,术中严重心律失常发生率,一次性建立动-静脉轨道成功率。结果研究共纳入患者312例,两组患者年龄、体重、性别等临床资料差异无统计学意义(P>0.05)。两组患者放射曝光时间比较差异无统计学意义(P>0.05)。术中A组心律失常发生率(53.6%)比B组(10.2%)明显增加,差异具有统计学意义(P<0.01);A组一次性建立轨道成功率(99.4%)比B组(95.8%)高,差异具有统计学意义(P<0.01)。结论去头猪尾管过室间隔法一次性建立轨道成功率高,但术中心律失常发生率增加,因此,对手术患者应权衡利弊。对于膜部室间隔缺损伴假性纤维瘤形成,且瘤体右心室面有多个破口,选择去头猪尾管过室间隔法成功率高;如果室间隔分流速度大,且室间隔左心室面缺损小,建议优先使用漂导丝法。
Objective To compare the advantages and disadvantages of the drift guidewire method and the detrusor pigtail approach to the interventricular septum defect in interventional closure therapy. Methods From February 2014 to April 2015, we retrospectively analyzed the patients with ventricular septal defect occluded by peri-ventricular septal defect occured in the Second West China Hospital of Sichuan University from February 2014 to April 2015. Group A was established by orbital piggyback inter- Intraoperative use of the guide wire method to establish orbit B group. Comparison of two methods of radiation exposure time, intraoperative incidence of serious arrhythmia, one-time establishment of the success rate of arteriovenous orbit. Results A total of 312 patients were enrolled in the study. There was no significant difference in age, weight, gender and other clinical data between the two groups (P> 0.05). Radiation exposure time between the two groups showed no significant difference (P> 0.05). The incidence of arrhythmia in group A (53.6%) was significantly higher than that in group B (10.2%), the difference was statistically significant (P <0.01). The success rate of group A orbital 99.4% %), The difference was statistically significant (P <0.01). Conclusion The success rate of one-off orbital tracheal-septal one-time orbit establishment is high, but the incidence of arrhythmia in operation is increased. Therefore, pros and cons should be weighed against patients undergoing surgery. For membranous ventricular septal defect with pseudo-fibroma formation, and the tumor right ventricular surface with multiple openings, choose to go head pig tail through the interventricular septum success rate; if the ventricular septum diversion speed, and ventricular septal left ventricular surface Small defects, it is recommended to use the drift wire method.