双盘封堵器治疗室间隔缺损及随访  

The treatment of VSD with home-made occluder and its mid-term and long-term results

作　　者：金恒[1] 赵刚[1] 吴红萍[1] 姜智明[1] 

机构地区：[1]江苏省南通市第一人民医院心内科,226001

出　　处：《介入放射学杂志》2010年第2期121-123,共3页Journal of Interventional Radiology

摘　　要：目的探讨双盘封堵器在治疗室间隔缺损(VSD)的应用效果以及中长期随访结果。方法2004年1月至2007年5月入住我院的VSD患者78例,于X线下行经皮VSD封堵术,术后1周内、3个月、1和2年的随访观察经胸超声心动图(TTE),心电图(ECG),24h动态心电图(Holter)等检查。结果73例双盘封堵器植入成功,技术成功率93.6%(73/78),封堵器直径为5～16mm,平均(10.3±3.2)mm;73例患者均完成全程随访,随访率100%。术后1周TTE随访,8例有残余分流,3个月时5例有残余分流,1、2年时随访残余分流消失。术后心律失常的随访,1周内偶发的房性早搏或室性早搏28例(38.4%),2例(2.72%)于封堵术后3d发生Ⅲ度房室传导阻滞,应用泼尼松及营养心肌药物治疗4～10d后消失。术后1、2年随访束支传导阻滞8例(10.1%)。结论双盘封堵器治疗VSD安全、有效,但术后需严密随访。Objective To evaluate the home-made occluder in the treatment of VSD and its mid-term and long-term results.Methods From Jan.2004 to May 2007, percutaneous VSD closure therapy under Xray monitoring was performed in 78 consecutive VSD patients, including 43 males and 35 females with an average age of（16.5 ± 8.6） years（ranged 3-37 years）.TTE, ECG and Holter examinations were performed in 1 week, 3 months, 1 year and 2 years after the procedure.Results Seventy-three home-made occluder devices with a diameter of 5-16 mm（10.3±3.2 mm） were implanted successfully, with a technical successful rate of 93.6%（73 / 78）.The whole course follow-up were carried out in all 73 successful cases（100%）.One week after the procedure TTE detected residual shunt in 8 cases, and three months later the residual shunt was observed in 5 cases.Follow-up check at one and two years after the treatment the residual shunt disappeared completely.For the observation of arrhythmia, occasional atrial premature beats or ventricular premature beats occurred in 28 cases（38.4%） within one week after the procedure, and two patients developed grade Ⅲ complete atrioventricular block at the third day after the surgery.The arrhythmia disappeared after medication of prednisone and nutrient drugs for 4-10 days.Bundle branch blocks were observed in 8 cases（10.1%） at one-year and two-year follow-up.Conclusion For the treatment of VSD, the home-made Amplatzer occluder device is reliable and effective, although a close follow-up is required after the surgery.

关 键 词：室间隔缺损 国产封堵器 治疗 

分 类 号：R541.1[医药卫生—心血管疾病]