目的 比较外科微创封堵术与经导管介入封堵治疗房间隔缺损的临床特征,为房间隔缺损患者选择治疗方法.方法 回顾性分析2009年7月至2010年6月在我院接受介入治疗的房间隔缺损病例321例,其中行外科微创封堵154例(组A),行导管介入封堵治疗167例(组B).结果 组A手术成功率98.7％,手术时间(61.45±23.57)min,术后住院时间(5.06 ±2.01)d,并发症发生率20.1％,住院费用(2.94±0.42)万元.组B手术成功率98.8％,手术时间(25.28±10.56)min,术后住院时间(3.41±0.70)d,并发症发生率3.0％,住院费用(2.11±0.32)万元.随访3～12个月,无死亡病例.结论 两种治疗方法均可有效地治疗单纯房间隔缺损,均有较高的成功率,外科微创封堵适应证广泛,无X线辐射,操作简单,易于推广；介入治疗住院时间短,创伤小,并发症少,住院费用低,有好的临床应用前景.%Objective To select the better treatment for atrial septal defect by comparing mini-invasive surgery and transcatheter closure. Methods 321 patients were enrolled in this study. 154 patients were treated by mini-invasive surgery (group A), and 167 patients were treated by tranacatheter closure ( group B ). Results The success rate of group A was 98. 7%. Operation time was (61. 45 ± 23.57) min. Hospital stay after operation was (5.06 ± 2.01) d. The incidence of postoperative complications was 20. 1 % . Cost of hospitalization was (29. 4 ± 4. 2) thousand yuans. The success rate of group B was 98. 8% . Operation time was ( 25. 28 ± 10. 56 ) min. Hospital stay after operation was ( 3. 41 ± 0. 70 ) d. The incidence of complications was 3. 0%. Cost of hospitalization was (21. 1 ±3. 2) thousand yuans. All cases were followed-up for an average of 10. 1 months (range. 3-12 months) and no patient died during this period. Conclusions Both ways were ripe for simple secundun atrial septal defect and each had its specified dominance. The mini-invasive surgery is superior than transcatheter closure in terms of wide indications, simplicity .radiation damage, but transcatheter closure had a shorter time to be in hospital and had the adventage of smaller wound a, less complications and less cost of hospitalization.
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