目的：研究改良小切口经右胸壁食道超声引导下封堵治疗房间隔缺损的临床效果。方法选取我院收治的23例继发孔房间隔缺损患儿，均在全麻食道超声引导下经右腋下胸壁小切口行房间隔缺损封堵术进行治疗，并与术后第2 d 口服阿司匹林肠溶片，服用6个月。结果23例患儿均封堵成功，手术操作时间31～65 min，平均（50.8±9.9） min，术后住院时间4～7 d，平均（5.8±1.2）d，随访1个月～1年，复查心脏超声无残余分流，二尖瓣、三尖瓣无反流，封堵伞无移位。结论改良右腋下小切口经胸壁食道超声引导下封堵治疗房间隔缺损是一种操作简单、创伤小、安全的手术方法。%Objective To study the clinical effect of improved transcatheter occlusion of ASD by right axillary mini-thoracotomy via transesophageal echocardiography through right chest. Methods 23 children of secundum atrial septal defect in our hospital were treated with improved transcatheter occlusion of ASD by right axillary mini-thoracotomy via transesophageal echocardiography through right chest under general anesthesia. All the patients started to take oral aspirin enteric-coated tablets, after 2 days of oral administration of aspirin enteric-coated tablets, taking 6 months. Results 23 children were occluded successfully. The time of operation were 31~65 minutes, average time was (50.8±9.9) min. The hospital stays after operation were 4~7 days, average time was (5.8±1.2) days. Followed up for 1 month to 1 year, cardiac uhrasonography reexamination showed that no residual shunts, no regurgitation on mitral valve and tricuspid valve, no occluder device shift happened. Conclusion Modified right armpit small incision through the chest wall and esophagus under ultrasound guidance for the treatment of atrial septal defect is a simple operation, small trauma, safe operation method.
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