Objective To study the effect of endoscopic repair in the treatment of patients with atrial septal defect and the effect of tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), serum cell adhesion molecules (ICAM-I), car-diac troponin I (cTnI).Methods From March 2014 to February 2016, according to the order of admission , 78 patients with atrial septal defect were divided into observation group and control group .The observation group was used to complete the re-pair under thoracoscopy , and the control group was treated with conventional median thoracotomy .The changes of TNF-α, IL-6, ICAM-1 and cTnI were compared between the two groups before and after operation .Results The aorta block time and ex-tracorporeal circulation time of the observation group were significantly longer than those in the control group [(25.43 ±2.43) min vs.(18.96 ±1.23) min,(65.43 ±5.32) min vs.(41.58 ±4.03), t =14.835, t =22.317, P =0.000], the intraop-erative blood loss was significantly less than the control group [(142.54 ±14.67) ml vs.(187.48 ±18.54) ml, t =11.871, P <0.01], the difference was statistically significant ( P <0.05).The hematocrit and hematocrit of the two groups had no significant difference ( P >0.05).The time of ventilator assistance, the amount of blood transfusion, the amount of drainage and the length of hospital stay were significantly lower in observation group than those in control group ( P <0.05).The lev-els of TNF-α, IL-6, ICAM-1 and cTnI in the observation group after surgery were significantly lower than those in the control group[(3.23 ±0.31) μg /L, (134.32 ±13.45) μg /L, (287.32 ±21.43) L, (2.75 ±0.23) μg /L vs.(4.39 ±0.46)μg /L, (174.32 ±15.32) μg /L, (314.21 ±32.05) ,(3.23 ±0.42)μg/L, t =13.060, t =12.253, t =4.356, t =6.260, P <0.01].Conclusion It suggested that the thoracoscopic repair in patients with atrial septal defect had little in -fluence on the severity factor level of patients , with mild body tissues and myocardial damage , as well quickly recovery and effective operation .%目的 研究胸腔镜下修补术治疗房间隔缺损患者的效果及对血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、血清细胞黏附分子(ICAM-I)、心肌肌钙蛋白I(cTnI)等的影响.方法 选择2014年3月—2016年2月内蒙古医科大学附属医院收治的房间隔缺损患者78例,根据患者入院顺序分为观察组和对照组,每组39例.观察组在胸腔镜下完成修补术,对照组采用传统正中开胸心脏手术.比较2组患者术中、术后情况及术前和术后血清TNF-α、IL-6、ICAM-I、cTnI变化情况.结果 观察组的主动脉阻断时间、体外循环时间显著长于对照组[(25.43±2.43)min vs.(18.96±1.23)min、(65.43±5.32)min vs.(41.58±4.03)min,t=14.835、22.317,P=0.000],术中出血量显著少于对照组[(142.54±14.67)ml vs.(187.48±18.54)ml,t=11.871,P<0.01];,2组患者的转中红细胞压积、停机红细胞压积比较差异无统计学意义(P>0.05).观察组的术后输血率、呼吸机辅助时间、术后24 h引流量、住院时间显著少于对照组(P<0.05).观察组术后的TNF-α、IL-6、ICAM-I、cTnI明显低于对照组[(3.23±0.31)μg/L vs.(4.39±0.46)μg/L、(134.32±13.45)μg/L vs.(174.32±15.32)μg/L、(287.32±21.43)μg/L vs.(314.21±32.05)μg/L、(2.75±0.23)μg/L vs.(3.23±0.42)μg/L,t=13.060、12.253、4.356、6.260,P<0.01].结论 胸腔镜下修补术治疗房间隔缺损对患者血清炎性因子水平影响较小,心肌损伤较轻,且安全有效.
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