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目的观察微创手术治疗房间隔缺损的疗效。方法选择房间隔缺损患者21例,取胸骨右旁第4肋间做3cm切口,切开心包并悬吊,于右心房壁缝双荷包线,并切开,将输送导管(国产)插入右心房内,通过房间隔缺损口入左心房,在经左胸壁超声监视下,释放出房间隔封堵伞,用保险绳做反复牵拉试验,确认封堵伞位置合适,再做一针贯穿右房壁和伞边缘的褥式缝合固定。结果全部患者手术过程顺利,平均手术时间60min,其中平均心内操作15min。患者住院5～7d,术后2～6个月复查,心脏彩超检查封堵伞无移位,无残余分流。结论在经胸壁超声监视下房间隔缺损封堵术是一种微创、安全、简便的治疗方法。
Objective To observe the curative effect of minimally invasive surgery on atrial septal defect. Methods Twenty-one patients with atrial septal defect were selected. A 3 cm incision was made on the fourth intercostal space of the right side of the sternum. The pericardium was dissected and suspended. A double purse was sewn on the right atrial wall and incised. The catheter was inserted into the right atrium , Atrial septal defect into the left atrium through the left chest wall ultrasound monitoring, the release of atrial septal plug blocking umbrella, with a safety rope to pull the test repeatedly to confirm the location of the appropriate closure of the umbrella, do a needle through the right atrium Mattress suture wall and umbrella edges. Results All patients underwent a successful operation with an average operation time of 60 minutes, with an average intracardiac operation of 15 minutes. Patients were hospitalized 5 ~ 7d, 2 to 6 months after the review, echocardiography examination of paracentesis no shift, no residual shunt. Conclusion Transcatheter closure of atrial septal defect using trans-thoracic ultrasound is a minimally invasive, safe and easy treatment.