宋振江　李晓峰　柏松　刘晖　赵宇东　沈磊

[摘要] 目的 探析先天性心脏病房间隔缺损进行介入疗法的心功能指标的临床观察。 方法 选择首都医科大学附属北京儿童医院2013年5月～2014年4月先心病房间隔缺损患者90例，根据随机数字表法分为对照组、实验组，每组各45例。实验组进行封堵器介入疗法，对照组进行外科手术疗法，进行彩色多普勒超声检查。比较两组手术情况，治疗前、治疗后的心功能各项临床指标情况以及并发症情况等。 结果 实验组手术时间、术中出血量及住院时间均优于对照组，差异有统计学意义（P < 0.05）；实验组、对照组总有效率分别为93.33%、95.56%，两组比较差异无统计学意义（P > 0.05）；实验组术后并发症（2.22%）明显低于对照组（17.78%），差异有统计学意义（P < 0.05）；术后两组的左心室射血分数、肺动脉内径、右心室横径、右心室长径、右心房横径、右心房长径等指标均有改善（P < 0.01），但术后实验组各指标显著优于对照组，差异均有统计学意义（P < 0.05）。 结论 先心病房间隔缺损使用封堵器介入治疗可获得与手术治疗相同的效果，而封堵器治疗时间短，术后恢复快，并发症少，值得临床推广。

[关键词] 封堵器介入术；房间隔缺损；临床研究；心功能

[中图分类号] R540 [文献标识码] A [文章编号] 1673-7210（2015）10（b）-0055-04

Control study of cardiac function before and after interventional therapy in atrial septal defect of congenital heart disease

SONG Zhenjiang LI Xiaofeng▲ BAI Song LIU Hui ZHAO Yudong SHEN Lei

Department of Cardiac Surgery， Beijing Children's Hospital， Capital Medical University， Beijing 100045， China

[Abstract] Objective To make the clinical observation on the cardiac function index before and after interventional therapy in atrial septal defect of congenital heart disease. Methods 90 patients with atrial septal defect of congenital heart disease treated from May 2013 to April 2014 in Beijing Children's Hospital， Capital Medical University were selected and randomly divided into control group and experimental group， 45 cases in each group. The experimental group was given the interventional therapy of using occluder； the control group was given the surgical operation. Through color Doppler ultrasound. The cardiac function index of two groups before and after treatment was compared. Results In the experimental group， the operation time， intraoperative bleeding and hospitalization time were better than the control group， the differences were statistically significant （P < 0.05）. The total effective rate of the experimental group and the control group was 93.33%， 95.56% respectively， the difference between the two groups was no significant （P > 0.05）； the incidence rate of the experimental group （2.22%） was significantly lower than that of the control group （17.78%）， the difference was statistically significant （P < 0.05）. The index like LVEF， inner diameter of PA， transverse diameter of RV， length of RV， transverse diameter of Ra， length of Ra in the two groups were improved after operation （P < 0.01）. However， the index like LVEF， inner diameter of PA， transverse diameter of RV， length of RV， transverse diameter of Ra， length of Ra of experimental group was significantly better than those of control group （P < 0.05）. Conclusion Interventional therapy of atrial septal defect of congenital heart disease using occlude has the same effect with operative treatment， and the therapy has short cure time， resume fast after the operation， less complication， it is worthy of clinical promotion.

[Key words] Interventional therapy of using occluder； Atrial septal defect； Clinical study； Cardiac function

房间隔缺损是指在胎儿胚胎发育中房间隔产生异常，引发左、右心房之间出现间隙，是临床常见的先天性心脏畸形，可合并其他类型的心血管畸形，也可单独出现[1]。房间隔缺损多为女性患者，其发病率约为男性患者的3倍。先天性房间隔缺损可导致心房水平分流，引发心脏房室间血流动力学障碍，如未能及时有效诊治，可对患者的生命健康和生活质量造成严重影响，甚至危及生命[2]。有文献显示，先心病房间隔缺损进行封堵器介入术疗法，可显著改善患者的心功能指标，临床效果确切[3]。探析先心病房间隔缺损的最佳治疗方式具有重要的临床价值。

1 资料与方法

1.1一般资料

选择2013年5月～2014年4月首……