经导管封堵先天性室间隔缺损的临床疗效分析  

Clinical effects of transcatheter occlusion of congenital ventricular septal defects

作　　者：宋治远[1] 何国祥[1] 舒茂琴[1] 胡厚源[1] 郭燕丽[2] 张平[2] 仝识非[1] 冉擘力[1] 刘建平[1] 姚青[1] 李永华[1] 

机构地区：[1]第三军医大学西南医院心血管内科,重庆400038 [2]第三军医大学西南医院超声科,重庆400038

出　　处：《重庆医学》2006年第3期194-195,共2页Chongqing medicine

基　　金：西南医院临床研究资助项目(SW2004017)

摘　　要：目的评估经导管封堵室间隔缺损（VSD）的临床疗效与安全性。方法先行左室造影了解VSD的形态、位置及大小，建立跨VSD的动静脉导丝轨道，并沿轨道导丝经静脉放入传送鞘管及封堵器，经心脏超声检测厦左室、主动脉造影证实封堵器位置合适后将其释放。术后定期随访．复查心脏超声及心电图。结果181例VSD患者中175例封堵治疗获得成功，成功率96．7％。封堵成功者中有162例完成了（15．4±9．23）个月（1个月～3年）的随访，1例于术后10h发生溶血反应，经治疗3d后恢复正常；2例分别于术后第4天及第6天发生间歇性完全性房室传导阻滞，经大剂量氢化可的松等治疗后恢复；无严重并发症发生。结论经导管封堵VSD是一项安全、有效的治疗手段．可使VSD患者得到根治。Oblective To evaluate the clinical effects and security of transcatheter occlusion of ventricular septal defect（VSD）. Methods After getting the configuration, location and diameter of VSD by left ventriculography, artery-vein steel wire track across the VSD was formed, then the long sheath and occluder was passed over the wire from the femoral vein. The device was released only when its position was checked optimal by eehocardiography, left ventriculography and aortography. During the regular follow-up, patients were rechecked by echocardiography and ECG. Results One hundred and seventy-five of all the 181 cases was successfully occluded, with a success rate of 96.7%. One hundred and sixty-two cases of them were followed up for （15.4 ± 9.23） months（1 month to 3 years）. One case of hemolysis occurred at 10h after operation, and recovered after 3d treatment; 2 cases of intermittent complete atrioventricular block occured respectively at 4d and 6d after operation, and cured after treating with large dose of glucocorticoid. No severe complication occurred. Conclusion Transcatheter occlusion of VSD is safe and effective. VSD can be cured by this way.

关 键 词：室间隔缺损 经心导管治疗 先天性心脏病 

分 类 号：R541.1[医药卫生—心血管疾病]