Amplatzer法房间隔缺损封堵术术后17例5年随访观察  

Five Years Follow-Up in Children with Secundum Artrial Septal Defect Using Amplatzer Occluder Device

作　　者：李涛[1] 潘同国[1] 王作军[1] 张家荣[1] 

机构地区：[1]郧阳医学院附属太和医院儿科,湖北十堰442000

出　　处：《实用儿科临床杂志》2005年第7期702-703,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的对Amplatzer法房间隔缺损(ASD)封堵术后进行5年随访观察,以客观评价疗效。方法对17例ASD患儿在透视及B超监视下经导管置入Amplatzer封堵器封堵ASD,术后即刻、48、1、3、6个月,1、2、3、4、5年,分别行体检、彩超、胸片、心电图检查。结果心脏杂音消失或减轻,并频发室性期前收缩、短阵室速者,术后即刻消失,ST-T改变者,术后心电好转。心脏B超示术后1个月右心负荷明显改善。1例残余分流者,术后1个月消失。1例术后3年诉夜间心内有“弹簧样”感觉,考虑为心理因素。1例置入34mm内径封堵器者,术后出现剧烈头痛,肝素静推后2h缓解,可能为脑微血栓所致。结论Am-platzer法ASD封堵术在儿童是安全、有效的。置入较大封堵器者,术后静脉应给予肝素2d,以防脑血栓。Objective To evaluate the efficiency of transcatheter closure of secundum artrial septal defect (ASD) using Amplatzer occluder device in 5 years.Methods There were 18 children with ASD.Each ASD was occluded using Amplatzer occluder device through the percutaneous procedure.The closure procedure was guided by fluoroscopy and transthoracic echocardiography.All patients were followed up by physical examination,color flow echocardiography,chest radition,electrocardiography at 48 h,1month,3 month,6 month,one year,two years,three years,four years and five years.Results Cardiac murmur disappeared or lightened.Arrhythmia and right heart volume in all patients were improved after the procedure.A case revealed a trival shunt of short duration and vanished after one month color flow echo.A case has “spring′s beat” in heart when she goes to bed in three years after the procedure.Another patient had serious headach after closure and recoved after heparin therapy.Conclusions Transcatheter closure of secundum ASD using amplatzer occluder device is safe and efficient by follow-up.In order to prevent cerebral embolism,heparin should be injected in vein in two days.

关 键 词：AMPLATZER封堵器 房间隔缺损 随访观察 

分 类 号：R726.5[医药卫生—儿科]