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目的 对比分析婴幼儿先天性房间隔缺损食道超声引导下经胸微创封堵术与经皮股静脉微创封堵术及传统开胸手术三种手术方法的效果差异.方法 选取2013年9月—2017年3月收治的68例单纯先天性房间隔缺损患儿作为研究对象.依据手术方式的不同将68例患儿分成食道超声引导下经胸微创封堵组(A组,n=20)和食道超声引导下经皮股静脉微创封堵组(B组,n=5)以及传统开胸手术组(C组,n=43).回顾性分析三组患儿的临床资料,并对比分析其手术成功率、术后残余分流出现率、术后短期并发症情况(新出现的心律失常、瓣膜反流、气胸、肺炎、封堵器脱落等)、手术时间、术后机械通气时间、术后住院时间等.结果 三组患儿手术全部顺利完成,术后均无残余分流,在手术成功率、术后残余分流方面差异无统计学意义.A组、B组术后均无明显短期并发症出现,C组术后出现气胸1例、肺炎3例、胸腔积液1例,A、B两组患儿术后短期并发症发生率差异无统计学意义,但与C组差异有统计学意义(P<0.05).B组手术时间最短,与A组差异有统计学意义(P<0.05),C组手术时间最长,与B组差异有统计学意义(P<0.05).A、B两组患儿术后机械通气时间、住院天数差异无统计学意义,较C组患儿缩短,差异有统计学意义(P<0.05).结论 婴幼儿先天性房间隔缺损食道超声引导下经胸微创封堵术及经皮股静脉微创封堵术较传统开胸手术术后并发症发生率低、手术时间短、创伤小、术后机械通气及住院天数缩短,安全可靠,经皮股静脉微创封堵术手术时间最短,但三种方法均需掌握好适应证.“,”Objective To compare and analyze the treatment effect of transesophageal ultrasound guided transthoracic minimally invasive closure, percutaneous femoral vein minimally invasive closure and traditional operation in the treatment of infants congenital atrial septal defect (ASD). Methods From September 2013 to March 2017, 68 infants with congenital ASD treated in our hospital were selected as the subjects. According to the different therapeutic method, these infants were divided into three groups, transesophageal ultrasound guided Transthoracic minimally invasive closure group (group A, n=20), percutaneous femoral vein minimally invasive closure group (group B, n=5) and traditional operation group (group C, n=43). We retrospectively analysed the clinical data of the three groups of infants, and compared their operation success rate, residual shunt occurrence rate, short-term complications after operation (emerging arrhythmias, valve regurgitation, pneumothorax, pneumonia, postoperative dislodgement of occlusion device, etc.), the time of operation, the time of mechanical ventilation and the length of hospital stay. Results The operations of all the three groups were completed successfully, there was no residual shunt after operation, so there was no statistical difference. There were no obvious short-term complications in group A and group B, and there were 1 case of pneumothorax, 3 cases of pneumonia and 1 case of pleural effusion after operation in group C. There was no difference in the occurrence of short-term complications in group A and group B, but there was statistical difference (P<0.05) compared with that of group C. The operation time of group B was the shortest, compared with that of group A, the difference was statistically significant (P<0.05), the operation time of group C was the longest, compared with that of group B, the difference was statistically significant (P<0.05). There was no difference between group A and B in the mechanical ventilation time and the length of hospital stay. Compared with that of group C, the difference was statistically significant (P<0.05). Conclusion Compared with infant congenital ASD traditional operation, transesophageal echocardiography guided transthoracic minimally invasive occlusion and percutaneous femoral vein occlusion have low complication rate, shorter operation time, less trauma, less postoperative mechanical ventilation time and shorter hospitalization stay. So, the two methods are safe and reliable. Percutaneous femoral vein minimally invasive closure has the shortest operation time. However, three kinds of surgical methods need to master the indications.