同期介入治疗先天性心脏病复合畸形  

Combined Congenital Heart Diseases Treated with Simultaneous Transcatheter Therapy

作　　者：罗瑞芳[1] 陈景伟[1] 钟焕清[1] 夏天[1] 赖锋华[1] 刘浪[1] 钟汝核[1] 

机构地区：[1]广东省高州市人民医院心血管中心,广东高州525200

出　　处：《中国现代医生》2009年第19期9-10,20,共3页China Modern Doctor

摘　　要：目的探讨先天性心脏病复合畸形经导管同期介入治疗的可行性、治疗策略和疗效。方法2006年7月～2008年12月介入治疗先天性心脏病复合畸形共28例。先天性心脏病的复合畸形为室间隔缺损(VSD)并发房间隔缺损(ASD)4例,VSD并发动脉导管未闭(PDA)3例,ASD并发PDA8例,PDA并发肺动脉瓣狭窄(PS)2例,ASD并发PS11例。介入治疗的顺序依次为PS球囊扩张术、VSD封堵术、PDA封堵术,最后行ASD封堵术。术后1个月、3个月、6个月和12个月随访检查心电图、X线胸片和超声心动图。结果28例复合畸形均一次性治疗成功。X线曝光时间平均(8.5±4.3)min,手术时间32～95min。1例VSD并ASD术后第4天发生Ⅱ度Ι型房室传导阻滞,予用药治疗后转窦性心律。余随访无不良并发症发生。结论严格掌握适应证,术中采取适当的治疗策略,先天性心脏病复合畸形的同期介入治疗可获得满意的效果。Objective To investigate the feasibility, therapeutic tactic and effect of simultaneous transcatheter therapy of combined congenital heart diseases. Methods Total 28 patients from Jul 2006 to Dec 2008 have combined congenital heart diseases including 4 cases of ventricular septal defects （VSD）and atrial septal defects （ASD）, 3 of VSD and patent duetus arteriosus （PDA）, 8 of ASD and PDA, 2 of PDA and pulmonary stenosis （PS）, 11 of ASD and PS. They underwent transcatheter therapy simultaneously with the sequential algorithm as balloon pulmonary valvuloplasty at first, followed by the occlusion of VSD, then the occlusion of PDA, then ASD. Follow-up with EKG, chest X-ray and echography was undertaken 1,3,6 and 12 months after the procedures. Results All were performed successfully with average X-ray exposed time（8.5 ± 4.3 ）min and operation time 32 - 95min. 1 case of VSD and ASD had II type of atrioventricular heart block 4 days after operation. It disappeared by medicine therapy. No other complication occurred in follow-up. Conclusion Simultaneous transcatheter theraphy of combined congenital heart diseases can obtain satisfactory effect by strict indication control and appropriate therapeutic tactic.

关 键 词：放射学 介入性 先天性 心脏缺损 

分 类 号：R725.4[医药卫生—儿科]