经皮间隔心肌消融术治疗梗阻性肥厚型心肌病的近期疗效观察  

Acute results of percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy

作　　者：班努.库肯 马依彤[1] 

机构地区：[1]新疆医科大学第一附属医院冠心病科,新疆乌鲁木齐830054

出　　处：《新疆医科大学学报》2005年第12期1149-1150,1153,共3页Journal of Xinjiang Medical University

摘　　要：目的:评价经皮间隔心肌消融术(PTSMA)治疗梗阻性肥厚型心肌病(HOCM)的近期疗效及安全性.方法:对我院自2000年7月以来收治的6例HOCM患者行PTSMA术,分别在术前、术后及3个月后行超声心动图,记录室间隔厚度及左室流出道压力阶差(LVOTG).结果:6例PTSMA手术均获成功,术后自觉症状明显缓解,心功能恢复为Ⅰ～Ⅱ级.LVOTG术前平均(94.0±40.8)mmHg,术后即刻(33.7±18.7)mmHg,术后3个月(32.5±12.9)mmHg,差异有统计学意义(P<0.05).室间隔厚度术前平均(25.6±7.3)mm,术后1周(19.7±3.8)mm,术后3个月(15.5±4.2)mm,术后3个月与术前比较,差异有统计学意义(P<0.05).1例发生一过性Ⅲ°房室传导阻滞,2 h后恢复正常,2例发生完全性右束支传导阻滞.结论:PTSMA是HOCM的一种有效治疗方法,近期疗效好,但其远期疗效仍需进一步观察.Objective： To evaluate efficiency and safety of PTSMA in 6 patients. Methods： 6 patients with HOCM underwent PTSMA by Sigwart method. The thickness of septal myocardium and LVOTG were measured before and 3 months after PTSMA. Results： All the patients showed clinical improvement, NYHA Ⅰ～Ⅱ, LVOTG reduction was achieved in all the patients, the mean reduction from （94±40.8）mmHg to （33.7±18.7）mmHg after PTSMA and （32.5±12.9）mmHg after 3 months （P〈0.05）. IVS reduction from （25.6±7.3）mm to （19.7±3.8）mm after PTSMA and（15.5±4.2）mm after 3 months （P〈0.05）. Ⅲ° atrioventricular block and recovered in 2 h in 1 case, 2 patients occurrenced permanent right bundle branch block in 2 cases. Conclusion： PTSMA is an effective technique for reduction LVOTG and symptoms in HOCM, long term observation of larger series are necessary in order to determine the definitive significance of the procedure.

关 键 词：梗阻性肥厚型心肌病 化学消融 近期疗效 

分 类 号：R815[医药卫生—放射医学] R542.2[医药卫生—临床医学]