室间隔缺损介入治疗与外科修补术后血流动力学及心功能变化的对比研究  

Comparative study on changes of cardiac function and haemodynamics after transcatheter occlusure with surgical treatment in ventricular septal defect

作　　者：况立洪[1] 杨天和[1] 刘晓桥[1] 田翔[1] 谭洪文 蒋清安[1] 

机构地区：[1]贵州省人民医院心内科贵州省心血管病医院,贵阳550002

出　　处：《重庆医学》2008年第23期2710-2711,2713,共3页Chongqing medicine

摘　　要：目的探讨介入封堵与外科手术治疗对室间隔缺损(VSD)患者心功能及血流动力学的影响。方法选择VSD患者30例,其中16例行介入封堵治疗,14例行外科手术治疗,分别于术前及术后3d、1个月、3个月、6个月行超声心动图检查,观察瓣膜峰值流速、左心室大小及心功能变化。结果VSD介入组与外科手术组患者术后二尖瓣口及肺动脉瓣口峰值流速降低,三尖瓣口峰值流速增加,随访期间无明显改变。两组患者左心室舒张末期前后径(LVEDD)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室搏出量-左心室排血量(LVSV)于术后3d即显示明显减小,并随观察时间延长而进一步改善;但LVEF术后随访期间与术前比较均无明显变化。介入治疗组与外科手术组比较各项指标均无统计学差异。结论介入封堵术及外科手术治疗室间隔缺损均可迅速扭转血流动力学改变,有效改善左心室功能。Objective To approach the effect of transcatheter occlution and surgical procedures in the treatment of ventricular septal defec on cardiac function and haemodynamics. Methods Thirty study subjects with ventricular septal defect included 16 patients underwent transcatheter closure and 14 patients underwent surgical clouse. The parameters of haemodynamics and cardiac function were measured with echocardiogram befor procedures and 3d, 1 month,3 months and 6 months after procedures. Results During the follow-up after transcatheter or surgical clouse,in all cases the peak flow rate of mitral valve and pulmonary valve decreased,and the peak flow rate of tricupid valve increased. But compared with 3d after procedures, these values did not changed significantly during the follow-up for more than 3d. Whether transcatheter or surgery clouse, LVEDD, LVEDV, LVESV and LVSV decreased significantly on 3d after procedures, and the longer the time of the follow-up was, the further the parameters reduced. However,LVEF after both procedures did not improve during the follow up. Additonally, there was also no significant difference in the the above parameters between transcatheter group and surgery group. Conclusion Both transcatheter occlution and surgical procedures in the treatment of ventricular septal defec can lastly reverse the abnormal haemodynamics and efficiently improve left cardiac function.

关 键 词：室间隔缺损 介入封堵术 心脏外科手术 心功能 血流动力学 

分 类 号：R541.1[医药卫生—心血管疾病] R815[医药卫生—内科学]