肺动脉瓣狭窄合并房间隔缺损的介入治疗效果分析  

Combined percutaneous treatment in children with pulmonary valvular stenosis and atrial septal defect

作　　者：石萍[1] 杨杰[1] 杨敏[1] 刘莉莉[1] 孙若鹏[1] 赵翠芬[1] 王玉玮[1] 

机构地区：[1]山东大学齐鲁医院小儿科山东,济南250012

出　　处：《临床儿科杂志》2008年第5期381-383,共3页Journal of Clinical Pediatrics

摘　　要：目的探讨儿童先天性肺动脉瓣狭窄合并房间隔缺损的介入治疗方法和临床随访效果。方法27例肺动脉瓣狭窄合并房间隔缺损的患儿,同时进行肺动脉瓣成形术和房间隔缺损封堵术,术后即刻、1周、3个月、6个月行超声心动图检查,随访其临床效果。结果27例经皮球囊肺动脉瓣成形术均获得成功,术后即刻测量跨肺动脉瓣压力阶差由术前的(79±62)mmHg降至(49±36)mmHg,术后超声心动图随访过程中跨肺动脉瓣压力阶差持续下降。超声心动图测量房间隔缺损直径为3.4～24.6(11.7±6.9)mm,选择封堵器的直径为8～32(14.6±8.7)mm,27例中有24例成功进行封堵。结论介入治疗肺动脉瓣狭窄并房间隔缺损是一种安全可靠的方法,严格掌握适应证,特别是房间隔缺损的适应证,可取得良好的临床效果。Objectives To investigate the methodology and follow-up results for combined percutaneous treatment in children with congenital pulmonary valvular stenosis and atrial septal defect. Methods Twenty-seven patients with pulmonary valvular stenosis and atrial septal defect were treated percutaneously. Transthoracic echocardiography was performed immediately after the procedure and also on the first, third and sixth month later to follow up the outcome. Resuits Balloon pulmonary valvuloplasty was performed successfully in all patients. After the procedure, transvalvular pressure gradient decreased from （79 ± 62） mmHg to （49 ± 36） mmHg. The transvalvular gradient decreased continuously during the follow-up. The atrial septal defect echo diameter was 3.4 - 24.6 （ 11.7 ± 6.9） mm, the occlusion device diameter was 8 - 32 （ 14.6 ± 8.7） mm, and the devices were successfully implanted in 24 cases. Conclusions Combined percutaneous treatment in children with pulmonary valvular stenosis and atrial septal defect is effective and safe, provided that stringent indication is observed, especially for cases of atrial septal defect.

关 键 词：肺动脉瓣狭窄 房间隔缺损 球囊瓣膜成形术 经导管封堵 

分 类 号：R725.4[医药卫生—儿科]