介入治疗膜周部室间隔缺损临床分析  

Clinical analysis of transcatheter closure of perimembranous ventricular septal defects using the Amplatzer occluder

作　　者：龚琪[1] 林薇[1] 王哲[1] 徐振海[1] 谈凌凌[1] 吕会来[1] 

机构地区：[1]河北医科大学第四医院胸心外科,石家庄市050011

出　　处：《中华实用诊断与治疗杂志》2009年第8期754-756,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的：回顾性分析应用Amplatzer封堵器治疗膜周部室间隔缺损的临床资料,以了解国产Amplatzer封堵器封堵治疗膜周部室间隔缺损的疗效。方法：对84例经超声心动图检查局部解剖结构满足封堵条件的先天性膜周部室间隔缺损患者,在局部麻醉或基础麻醉下行国产Amplatzer封堵器封堵治疗。手术中予以经胸超声心动图和X线监测。封堵成功者进行6~24个月的随访。结果：成功封堵83例（98.8%）,1例因术中导引钢丝无法通过室间隔缺损建立轨道,放弃封堵。无死亡。封堵器直径为4~18 mm,1例手术后发生Ⅱ度Ⅱ型房室传导阻滞,2例出现结性心律,经应用肾上腺皮质激素及异丙肾上腺素治疗后好转,3例有少量残余分流,随访过程中无严重并发症出现。结论：在严格掌握指征、规范手术操作方法的前提下,应用国产Amplatzer封堵器封堵膜周部室间隔缺损是一种安全、有效的治疗方法。Objective To report the result and experiences of percutaneous occlusion using an Amplatzer septal occluder in perimembranous ventricular septal defect.Methods Totally 84 patients with perimembranous ventricular septal defect underwent transcatheter interventional occlusion.After the procedure,all patients with successful occlusion were followed up from 6 to 24 months.Results Occlusion succeeded in 83 cases（98.8%）.Guide wire failed to go through ventricular septal defect in one patient.The diameter of Amplatzer septal occluder was 4 to 18 mm. One case had 2 degree type Ⅱ A V block and 2 cases had nodal rhythm. After treated with corticoid and isopropylarterenol, the arrhythmia disappeared completely in 1 week. Three patients had tiny residual shunt. During the follow-up period of all patients, there was no device-related complication. Conclusion The perimembranous ventricular septal defect closure with Amplatzer septal oecluder is safe and effective in most selected patients.

关 键 词：室间隔缺损 封堵器 介入治疗 

分 类 号：R541.1[医药卫生—心血管疾病]