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目的对房间隔缺损(ASD)、室间隔缺损(VSD)、动脉导管未闭(PDA)的介入治疗(Amplatzer封堵器)和外科手术治疗的临床疗效进行比较。方法研究对象为2004-05—2005-05在北京安贞医院小儿心脏科住院患儿80例,符合单一左向右分流畸形ASD、VSD、PDA,根据治疗方法不同分为介入组(40例)和手术组(40例);比较2组在疗效、费用、并发症、输血量及住院时间等方面的异同;通过放免法测定2组ASD及VSD治疗前后的心钠素(ANP)水平。结果2组手术成功率均为100%;介入组均未输血,手术组均输血治疗;术后住院时间介入组少于手术组(P<0.01);治疗费用介入组高于手术组(P<0.01);ANP水平,外科手术及介入治疗后均较治疗前降低。结论单一ASD、VSD、PDA的介入治疗与手术治疗临床效果相同;介入组不需输血,术后住院时间短,但治疗费用较昂贵。
Objective To compare the clinical effects of atrial septal defect (ASD), ventricular septal defect (VSD), PDA intervention (Amplatzer occluder) and surgical treatment. Methods The subjects were 80 children admitted to pediatric cardiology department of Anzhen Hospital, Beijing from May 2004 to May 2005, which met the criteria of single left-right shunt ASD, VSD and PDA. According to the different treatment methods, they were divided into intervention group (n = 40) And surgery group (40 cases). The similarities and differences of efficacy, cost, complications, blood transfusion and hospital stay between the two groups were compared. Atrial natriuretic peptide (ANP) levels were measured before and after ASD and VSD treatment by radioimmunoassay. Results The success rate of operation in both groups was 100%. No blood transfusion was given in the intervention group and blood transfusion in the operation group. The postoperative hospitalization time was shorter in the intervention group than in the operation group (P <0.01) 0.01). The levels of ANP, surgery and intervention decreased after treatment. Conclusion The interventional treatment of single ASD, VSD and PDA is the same as surgical treatment. The intervention group does not need blood transfusions and the postoperative hospitalization time is short, but the treatment cost is more expensive.