假性室间隔膜部瘤介入治疗的中期临床评价  

Clinical evaluation of transcatheter closure on pseudoaneurysm of perimembranous ventricular septum in intermediate term

作　　者：解启莲[1] 崔史杰[2] 高磊[1] 张密林[1] 王震[1] 朱晓丽[1] 刘坤申[1] 

机构地区：[1]河北医科大学第一医院心脏中心河北医科大学先天性心脏病诊疗中心,河北石家庄050031 [2]河北医科大学研究生院,河北石家庄050017

出　　处：《临床荟萃》2007年第5期315-317,共3页Clinical Focus

摘　　要：目的评价假性室间隔膜部瘤(PPVS)介入治疗的中期临床疗效。方法对2004年3月至2006年3月住我院采用国产室间隔缺损封堵器治疗的220例PPVS患者进行随访,平均随访(180±90)天。结果术后有28例患者存在室间隔水平残余分流,至6个月时残余分流全部消失;随访期间,3例术前存在轻度主动脉瓣反流的患者,2例反流消失,1例减轻;术前超声心动图检查发现伴有二尖瓣、三尖瓣反流的患者,其反流均有不同程度改善;术后12个月右心室流出道最大流速及右心室流出道腔径均较术前有改善[(160.4±36.5)cm/s vs(174.0±95.9)cm/s(P<0.05),(17.0±4.7)mm vs(14.4±4.3)mm(P<0.05)],而膜部瘤瘤体的最大横径与术前相比差异无统计学意义[(5.6±2.1)mm vs(5.5±2.4)mm(P>0.05)]。无死亡,无心内膜炎,无封堵器钢丝断裂,无新发主动脉瓣、二尖瓣和三尖瓣关闭不全等并发症发生,未出现新发心律失常患者。结论国产室间隔缺损封堵器治疗PPVS的中期随访结果安全有效,其远期效果值得期待。Objective To evaluate clinical effects of transcatheter closure on pseudoaneurysm of the perimembranous ventricular septum （PPVS） in the intermediate term. Methods Two hundred and twenty patients with PPVS closured with domestic ventricular septal defect occluder （VSO） from March 2004 to March 2006 were followed up for （180±90） days. Results After operation,there was residual shunt in 28 patients and all disappeared in six months. Light aortic regurgitations occurred in three patients before operation, then disappeared in two patients and lightened in one patient on follow up evaluation. Those patients who had mitral valve and tricuspid valve regurgitations diagnosed by echocardiogram before operation were improved more or less after the procedure. The maximum blood flow velocities and the diameter of right ventricular outflow tract after operation for 12 months was better than before operation[（160.4 ± 36.5） cm/s,（174.0±95.9） cm/s （P〈 0.05）,（17.0±4.7） mm,（14.4±4.3） mm（P〈0.05）],but the difference of the maximum transverse diameter of PPVS was not statistically significant[（5.6±2.1） mm, （5.5±2.4） mm（ P 〉0.05）]. All the patients were doing well during the scheduled intermediate term follow up. No episode of endocarditis, no procedure related death,no wire disruption, no new valve regurgitation and arrhythmia were recorded. Conclusion The intermediate term treatment efficiency of transcatheter closure on PPVS using domestic VSO are safe,effective and promising.

关 键 词：心脏室壁瘤 介入治疗 封堵器 随访研究 

分 类 号：R541[医药卫生—心血管疾病]