先天性心脏病经导管封堵术后机械性溶血的发生与防治  

Prevention and cure of hemolysis after transcatheter closure of congenital heart disease

作　　者：张倩[1] 舒茂琴[1] 胡厚源[1] 刘建平[1] 冉擘力[1] 宋治远[1] 

机构地区：[1]第三军医大学西南医院心内科重庆市介入心脏病学研究所,重庆400038

出　　处：《重庆医学》2006年第4期305-306,共2页Chongqing medicine

基　　金：西南医院临床研究资助项目资助(SW2004017)

摘　　要：目的探讨先心病经导管封堵术后机械性溶血的发生原因与防治措施。方法通过对1例室间隔缺损(VSD)封堵术后发生机械性溶血患者的病例特点及治疗效果资料进行回顾性分析,结合文献报道对先心病经导管封堵治疗后发生机械性溶血的原因与防治措施进行讨论。结果共438例先心病患者接受经导管封堵治疗,其中VSD 181例,房间隔缺损135例,动脉导管未闭122例。经导管封堵术后即刻发现35例有残余分流,其中1例VSD患者于术后10h发生机械性溶血,经用激素等治疗于术后72h病情好转,1周后治愈出院。结论先心病封堵术后机械性溶血的发生与封堵术后的残余分流有关,大剂量激素、碱化尿液及大量补液等对机械性溶血治疗有效。Objective To evaluate the cause and treatments of hemolysis after transcatheter closure of congenital heart disease. Methods The causes and treatments of mechanical hemolysis after transcatheter closure of congenital heart disease were discussed in the review of a ventricular septal defect（VSD）case and relative documents. Results Four hundreds and thirtyeight cases consisting of 181 patients with VSD, 135 patients with atrial septal defect and 122 patients with patent ductus arteriosus underwent transcatheter closure. Thirty-five cases were recorded occurrence of residue after transcatheter closure, of which one patient with VSD suffered hemolysis 10h later and resolved 72h later after the transcatheter closure following conservative therapy. Conclusion Hemolysis is strongly related to the occurrence of residue after transcatheter closure of congenital heart disease. The treatments of hormone administration, alkalinizing urine and fluid replacement are proved to be effective to resolve mechanical hemolysis.

关 键 词：先心病 经导管治疗 机械性溶血 

分 类 号：R725.4[医药卫生—儿科]