 |
 |
醫(yī)學(xué)免費(fèi)論文:國產(chǎn)封堵器治療先天性心臟病療效評價(jià)
【摘要】 目的：探討國產(chǎn)封堵器在先天性心臟病介入治療的臨床療效。方法：回顧分析2005年7月～2008年5月連續(xù)施行的先天性心臟病介入治療51例，其中動脈導(dǎo)管未閉(PDA)14例，房間隔缺損(ASD)27例 ，室間隔缺損10例 ，術(shù)中行即刻造影和或經(jīng)胸超聲心動圖(TTE)，術(shù)后5～7 d和半年復(fù)查經(jīng)胸超聲心動圖，觀察其手術(shù)安全性、術(shù)中和術(shù)后療效。結(jié)果：其中50例即刻獲得成功，成功率98%(50/51)。殘余分流1例，即刻完全封堵率98%(49/50)，無一例急癥手術(shù)或死亡�？諝馑ㄈ�0.6%(3/51)，一過性Ⅱ°房室傳導(dǎo)阻滯0.4%(2/51)。術(shù)后5～7 d和半年復(fù)查1例殘余分流。結(jié)論：應(yīng)用國產(chǎn)封堵器治療先天性心臟病成功率高，創(chuàng)傷小，死亡率低，安全有效。
【關(guān)鍵詞】 先天性心臟病 封堵術(shù) 經(jīng)胸超聲心動圖醫(yī).學(xué).全.在.線zxtf.net.cn
Therapeutic evaluation of Chinesemade amplatzer occluder device to treat congenital heart diseases
WU Zhongdong, JIANG Shubing, XU Lishu
(Department of Cardiology, Affiliated Traditional Chinese Medical Hospital,Xinjiang Medical University, Urumqi 830000, China)
Abstract: Objective: To evaluate the results of interventions in patients with congenital heart disease (CHD). Methods: The clinical effects of interventional therapy in consecutive patients with CHD at our hospital from July 2005 to May 2008 were retrospectively analyzed, and the patient distribution included patent ductus arteriosus (PDA)14 cases, atrial septal defect (ASD) 27 cases, ventricular septal defect (VSD)10 cases. An immediate angiography and transthoracic echocardiography (TTE) were used to observe the clinical effects. Results: Fifty cases were closed successfully, successful rate was 98%(50/51). Residual shunt was found in 1 case immediately and half a year. No mortality was observed. No surgical operation. Ⅱ°AVB in 2 cases(0.4%). Conclusion: Chinesemade Amplatzer occluder device to treat congenital heart diseases is effective and safe, there are no late complications, no mortality.
Key words: congenital heart disease; interventional therapy; transthoracic echocardiography
1997年Amplatz開發(fā)了新一代封堵器，因其具有不需開胸及體外循環(huán)、無手術(shù)疤痕、恢復(fù)快等優(yōu)點(diǎn)，使常見先天性心臟病介入治療進(jìn)入成熟階段[1]。而2000年國產(chǎn)器械的研制成功，進(jìn)一步促進(jìn)了介入治療的發(fā)展[2]。我院于2005年7月～2008年5月應(yīng)用國產(chǎn)先健TM封堵器治療先天性心臟病房間隔缺損(ASD)、動脈導(dǎo)管未閉(PDA)、室間隔缺損(VSD)共51例，并對其療效進(jìn)行觀察，現(xiàn)報(bào)告如下。
1資料與方法
1.1臨床資料封堵介入治療51例，男性20例，女性31例，年齡3～57歲，體重16～69 kg。PDA14例，ASD27例，VSD10例。超聲心動圖PDA管型5例，漏斗型9例，最狹窄處3～12 mm;ASD均為繼發(fā)孔中央型直徑4～32 mm;VSD膜部8例，直徑4～10 mm，并膜部瘤形成1例，嵴內(nèi)型1例。
1.2治療方法應(yīng)用國產(chǎn)先健TM封堵器及輸送系統(tǒng)進(jìn)行介入封堵治療。在X線透視、造影及經(jīng)胸超聲心動圖監(jiān)視下，按照常規(guī)方法行介入封堵術(shù)，術(shù)后常規(guī)抗炎、抗凝治療3 d，抗血小板治療3～6個(gè)月。選擇的封堵器直徑PDA為6～14 mm，ASD為8～42 mm，VSD為6～14 mm。患者均于術(shù)后5～7 d、術(shù)后半年查心電圖、胸透、經(jīng)胸超聲心動圖。
2結(jié)果
