【摘要】 目的:探究对可调弯鞘在颈内静脉微创房间隔缺损(ASD)封堵术中的应用。方法:本次研究以2016年3月至2017年3月,在我院进行在超声下引导下实施可调弯镜房间隔封堵术的20例心脏病患者作为研究对象。通过超声引导,实时调整鞘管的头端,选择合适封堵器材利用鞘管释放封堵伞。观察手术治疗效果,手术时间、心内操作时间以及术后并发症情况。结果:在术后并发症方面没有出现,血栓,心内分流,心内感染,心律失常,在整个住院时间内也没有出现死亡情况,手术过程中没有转开胸手术病例,同时也没有出现颈内静脉的损伤,颈部开口愈合良好,无不良情况发生。其中手术时间(27.1±5.8)min,心内操作中位数时间6.2min,也未出现封堵器移位和脱落的情况。右侧的颈内静脉要显著的大于右股静脉的直径,差异有统计学意义(P<0.05)。结论:作为一种新型的房间隔缺损的微创手术方法,经颈内静脉可调弯鞘封堵术相比于传统的方法在治疗上无论是在手术时间,手术结果和术后并发症上都有显著的优势,值得在房间隔治疗过程中应用。更多还原

【Abstract】 Objective: To investigate the application of adjustable curved sheath in transcatheter closure of atrial septal defect( ASD) with internal jugular vein. Methods: This study was conducted in March2016 March-2017 in our hospital under the guidance of ultrasound,the implementation of adjustable curved mirror room septum occlusion in 20 patients with heart disease as the research object. Through the ultrasonic guidance,the head of the sheath tube is adjusted in real time,the suitable plugging device is selected,and the occlusion umbrella is released by the sheath tube. The effect of operation,operation time,and postoperative complications were observed. Results: No postoperative complications of thrombosis,intracardiac shunt,cardiac arrhythmia,infection,no death in the hospitalization time,no open chest surgery patients underwent operation process,but also does not appear to damage the internal jugular vein,the neck opening healed well,no adverse events. Among them,the operation time( 27. 1 ± 5. 8) min,the median of the intracardiac operation time is 6. 2 min. No shift and abscission of the occluder occurred. The paired t test showed that the right internal jugular vein was significantly larger than the right femoral vein diameter,and there was statistical difference( P < 0. 05). Conclusion: As a new type of ASD in minimally invasive surgery method. Of internal jugular vein variable sheath occlusion compared to traditional treatment both in the operative time,operative result and postoperative complications have significant advantages,worthy of application in the treatment of ASD.更多还原