介入封堵治疗小儿先天性心脏病18例疗效分析  

Transcatheter closure to treat children congenital heart disease

作　　者：林惠泉[1] 付思源[1] 张家祥[1] 

机构地区：[1]漳州市医院儿科,363000

出　　处：《福建医药杂志》2006年第2期4-6,共3页Fujian Medical Journal

摘　　要：目的探讨应用进口或国产封堵器介入治疗小儿先天性心脏病的方法并评价其效果、安全性。方法超声心动图确诊的10例动脉导管未闭(PDA)、8例膜周部室间隔缺损(PMVSD)患者,均在X线透视及造影和经胸超声心动图(TTE)指引下经导管置入封堵器,术后24小时,1、3、6、12个月及以后每年分别行TTE、ECG和X线胸片检查评价治疗效果。结果10例PDA经造影测量PDA最窄处直径为2.5～8.5mm(平均4.2±1.6mm),选择封堵器直径6～14mm(平均8.5±1.8mm);8例PMVSD造影测量VSD直径2.8～6.5mm(平均4.4±2.1mm),选择封堵器直径5～9mm(平均6.5±1.8mm)。技术成功率为100%,术中未发生任何并发症,无急诊手术病例。术后即刻造影或TTE显示1例VSD存在残余分流,6个月后残余分流消失。其余病例无残余分流和再通,心室内径均有不同程度的缩小,肺动脉压下降。结论应用进口或国产封堵器经导管置入治疗小儿先天性心脏病,具有操作简便、安全、损伤小、成功率高等优点,是适合儿童部分类型PDA及PMVSD的介入方法。Objective To evaluate the therapeutic effect of transcatheter closure on patent ductus arteriosus （PDA） and perimembranous ventricular septal defect （PMVSD） by using China-made or imposed occluder device. Methods Eighteen patients, including 10 cases with PDA and eight cases with PMVSD, confirmed by transthoracic echocardiography （TTE）, were enrolled into the present study. All patients were treated with occluder devices through the percutancous procedure under fluoroscopy angiography and TTE guidance. Each patient underwent TTE, ECG and chest radiograph examinations at 24 hours and one, three, six, and 12 months after the procedure, and thereafter annually. Results The narrowest diameter of PDA and PMVSD ranged from 2.5 mm to 8.5 mm （average 4.24±1.6 mm） and 2. 8 mm to 6. 5 mm （average 4. 44±2. 1 mm）, respectively; the diameter of occluder selected ranged from 6 mm to 14 mm （average 8.54±1.8 mm） and 5 mm to 9 mm （average 6.5 4± 1.8 mm） in PDA and PMVSD, respectively. The occluder devices were deployed in 100% of 18 patients. No complications occurred during the procedure. Angiography or TTE examinations immediately after the procedure showed eleven cases were immediately complete closure of the defect, and only one case of PMVSD had trivial residual shunt. Follow-up of 1-12 months showed this case had completed abolition of the shunt after six months. TTE examinations showed the innerdiameter of ventricle and the pressure of pulmonary were improved in all cases. Conclusion Transcatheter closure with china-made or imported occluder device is simple, less harm to the patients, and with a high success rate; it is a safe and efficacious nonsurgical measure for the children suffered from PDA or PMVSD.

关 键 词：先天性心脏病 动脉导管未闭 膜部室间隔缺损 介入治疗 

分 类 号：R725.4[医药卫生—儿科]