经胸超声心动图在先天性心脏病介入封堵术中的应用  

Application of transthoracic echocardiography in interventional treatment of congenital heart diseases

作　　者：邓旦[1] 常明[1] 丁盛[2] 余永康[2] 吴凡[2] 赖小今[1] 

机构地区：[1]成都军区成都总医院超声科,成都610083 [2]成都军区成都总医院心胸外科,成都610083

出　　处：《解放军医学杂志》2007年第10期1079-1081,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨经胸超声心动图(TTE)在先天性心脏病介入封堵术中的应用价值。方法TTE筛选出26例房间隔缺损(ASD)、23例室间隔缺损(VSD)以及16例动脉导管未闭(PDA)的先天性心脏病患者行经导管国产封堵器介入封堵治疗,并应用TTE在封堵术中监测及在术后进行疗效评估。结果共61例患者成功地进行了介入封堵治疗,术后即刻TTE及X线造影均未见残余分流,各瓣膜未见病理性反流。术后1个月及3个月TTE复查,封堵器位置良好,无残余分流。3例室缺患者术后第2天出现不同程度的传导阻滞,经治疗后好转。2例ASD、2例VSD及1例PDA未完成封堵。总成功率为93.8%(61/65)。结论TTE在先天性心脏病介入封堵治疗术的术前病例筛选、术中监测和术后疗效评价中有重要价值。Objective To study the value of transthoracic echocardiography （TTE） in interventional treatment of congenital heart diseases. Methods TTE was used to identify patients with atrial septal defect （ASD, n=26）, ventricular septal defect （VSD, n=23） or ductus arteriosus （PDA, n= 16）. They received interventional treatment with domestic made nitinol occluder. The TTE was then used to monitor the entire process of the surgery and to assess the effect of the surgery. Results The treatment with indigenous nitinol occluder failed in five patients, including two with ASD, two with VSD, and one with PDA. The other sixty-one patients were freated successfully with the occluder. Once the procedure was completed, those patients were found to have neither abnormal valvular regurgination as shown by TTE, nor any shunt flow around the occluder as shown by both TTE and angiocardiography. One month later, TTE demonstrated that the position of all the occluclers remained stable, and no residual leakage or shunt was detected by TTE in all of the sixty-one patients, and the same results were obtained after three months. However, two days after the surgery, ECG showed that three of the patients with VSD suffered from different degrees of atrioventficular block on the second postoperative day, but they eventually recovered after treatment. The successful rate of the procedure was 93. 8% （61/65）. Conclusions Transthoracic echocardiography may play an important role at three stages （pre-, during- and after）, i.e. to select the most suitable patients before the procedure, accurately identify the location, and release of the occluder at the end of the operation; and finally, it serves as a promising method to evaluate the treatment result in patients during their follow-up period.

关 键 词：经胸超声心动图 先天性心脏病 介入治疗 

分 类 号：R543.5[医药卫生—心血管疾病]