目的 回顾分析急性心肌梗死（acute myocardial infarction，AMI）后合并室间隔穿孔（post⁃ infarction ventricular septal rupture，PIVSR）行外科修补手术或介入封堵术治疗的临床特征及预后情况。 方法 回顾性分析自 2017-2020 年于河南省人民医院心脏中心就诊并确诊为 PIVSR 的 64 例患者的临床资料，根据手术方式的不同分为介入封堵术组（n = 50）和外科修补手术组（n = 14），分析两组患者的基线资 料、术前、术中、术后相关结果及随访结局等。结果 与外科修补手术组相比，介入封堵术组女性多、穿孔 （VSR）直径小、病情相对轻、住院费用低、手术时间短、ICU 滞留时间短、术后残余分流比例高。随访结果 显示，两组患者的左室舒末径（LVEDD）、左心室射血分数（LVEF）、6 min 步行试验术后 1 个月和 6 个月之 间的差异及随访无死亡事件生存率差异均无统计学意义（P > 0.05）。在 Cox 回归分析中显示心功能 Killip 分级（Ⅱ⁃Ⅳ级）是影响两组患者生存的危险因素。结论 PIVSR 患者接受介入封堵术预后好，术后患者创伤小，恢复快，住院费用低，远期生存率较高，介入封堵术作为一种微创、有效的治疗方法，很可能成为外科手术修复的一种有价值的替代治疗。 

Objective To analyze the clinical features and prognosis of patients with post ⁃infarction ventricular septal rupture（PIVSR）undergoing surgical repair or transcatheter interventional closure. Methods The clinical data of 64 patients who were diagnosed with PIVSR at the Heart Center of Henan Provincial People′s Hospital from 2017 to 2020 were reviewed and analyzed. Those undergoing transcatheter interventional closure were assigned as intervention closure group（n = 50）and those undergoing surgical repair as surgical repair group（n = 14）. The baseline data，preoperative，intraoperative，and postoperative results and follow⁃up results were analyzed and compared between the two groups. Results Compared with the surgical repair group，the interventional closure group had a larger number of females，smaller VSR diameter，less severity of disease，lower hospitalization cost， shorter operation time，shorter ICU stay time，and higher residual shunt rate. Follow⁃up results showed that there were no statistically significant differences in left ventricular diastolic diameter（LVEDD），left ventricular ejection fraction（LVEF），6 min walking test one and six 6 months after the operation and the follow⁃up survival rate（P > 0.05）. The Cox regression analysis showed that the Killip classification of cardiac function（Class Ⅱ⁃Ⅳ）was a risk factor affecting the survival of the patients of the two groups. Conclusion PIVSR patients undergoing interventional closure have a good prognosis. After closure，the patients have little trauma，quick recovery，low hospitalization costs，and high long⁃term survival rate. As a minimally invasive and effective therapy，it is likely to become an alternative treatment.