国产对称型封堵器封堵膜部室间隔缺损的近期效果  

Recent effects of homemade symmetric ventricular septal occluder in treatment of perimembranous ventricular septal defect

作　　者：朱润硕[1] 徐岩[1] 程自平[1] 许邦龙[1] 陈斌[1] 吴继雄[1] 史学功[1] 

机构地区：[1]安徽医科大学第一附属医院心内科,安徽省合肥市230022

出　　处：《中国临床康复》2006年第33期110-112,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:观察应用国产对称型膜部室间隔缺损封堵器介入治疗膜部室间隔缺损的即刻及近期效果。方法:纳入2003-08/2005-04安徽医科大学第一附属医院心内科的住院患者45例,经胸心脏超声和左心室造影明确确诊为膜部室间隔缺损。采取经左心系统-室间隔缺损-右心系统建立导丝轨道,再经股静脉沿导丝经输送鞘送入封堵器的介入方法实施封堵。术后即刻、72h及1个月行经胸心脏超声复查。观察疗效。术后1个月随访超声心动图多项血流动力学指标。结果:①42例成功封堵,全组技术成功率93%,术中未发生任何严重的并发症。②已行封堵的全部患者术后均无残余分流,术后即刻完全封堵率100%。术后72h及1个月经胸心脏超声检查无残余分流。③1例术后5d出现Ⅲ度房室传导阻滞并阿-斯发作,2例患者术后出现一过性交界性心动过速,1例出现阵发性房颤,10例出现发热,经处理后均恢复正常。④1个月后血流动力学指标改善,左房内径、左室舒张末期内径、左室收缩末期内径、三尖瓣返流量术后均小于术前[术后1个月:(3.23±0.32),(4.54±0.63),(3.04±0.37)mm,(20.53±5.6)mL;术前:(3.61±0.59),(5.12±0.54),(3.34±0.45)mm,(28.27±7.12)mL,P<0.05]。结论:应用国产对称型膜部室间隔缺损封堵器,介入治疗膜部室间隔缺损损伤小、成功率高、安全可靠。AIM： To observe the therapeutic effects both instantly and recently of transcatheter closure of perimembranous ventricular septal defect （PMVSD） using symmetric ventricular septal occluder （SVSO） made in China. METHODS： A total of 45 inpatients from the Department of Cardiology, the First Affiliated Hospital of Anhui Medical University between August 2003 and April 2005. They were diagnosed as PMVSD by transthoracic echocardiography （TFE） and left ventricle imaging. With the filament path of left ventricle-PMVSD-right ventricle, SVSO was applied to perform transcatheter closure through the femoral vein. The successful cases were examined by rIFE instantly after operation, at postoperative 72 hours and postoperative 1 month to observe the curative effects. In addition, ultrasonic cardiogram was used to detect some hemodynamic index of patients in postoperative one-month follow-ups. RESULTS： ① There were 42 of 45 cases underwent the procedure successfully without serious complications. The success rate of the percutaneous procedure was 93%.②No residual shunts were found by TIE in 42 postoperative patients, with completely occluded rate of 100% instantly after operation. ③ There was 1 case presented Ⅲ degree atrioventricular block （AVB） complicating Adams-Stokes syndrome at postoperative 5 days, 2 cases presented temporary atrioventricular junctional tachycardia, 1 ease presented paroxysmal atrial fibrillation and 10 cases s.uffered from fever. However, those patients all recovered after treatment.④The hemodynamic index were improved 1 month later, and the left atrial diameter, left ventrieular end-systolic pressure and tricuspid regurgitation were all smaller postoperatively than preoperatively [Postoperative one-month： （3.23±0.32）, （4.54±0.63）, （3.04±0.37） mm, （20.53±5.6） mL; Preoperatively： （3.61±0.59）, （5.12±0.54）, （3.34±0.45） mm, （28.27±7.12） mL, P 〈 0.05]. CONCLUSION： The homemade SVSO is a safe and effective method for treat

关 键 词：室间隔缺损 心脏导管插入术 心脏 

分 类 号：R496[医药卫生—康复医学]