KMG微球栓塞术联合外科矫正术应用于法洛氏四联症的临床价值  

Application of Combined KMG Microballoons Embolization and Surgical Treatment for Tetralogy of Fallot

作　　者：吕涵[1] 王湛[1] 戴建新[1] 徐敬[2] 

机构地区：[1]河南职工医学院,郑州451191 [2]郑州大学第一附属医院心血管外科,郑州450052

出　　处：《河南职工医学院学报》2011年第6期660-662,共3页Journal of Henan Medical College For Staff and Workers

摘　　要：目的评价伴有丰富体肺侧支血管的重症法洛氏四联症患者联合应用海藻酸钠(KMG)微球栓塞术和外科矫正术的临床价值。方法 2004年2月～2008年1月,合计9例确诊为法洛氏四联症病人,于手术当天在造影引导下应用KMG微球栓塞体肺侧支血管并对心脏畸形实施外科矫正术。结果经造影证实共发现体肺侧支血管25支,对其中的20支(80%)成功进行了栓塞,共用KMG微球12瓶。部分适于手术结扎的血管在实施外科矫正术的同时进行术中结扎。结扎后实施心内畸形外科矫正术时体外循环灌注压稳定,侧支回血量明显减少,术野显露良好,手术时间缩短。术后8例痊愈,1例因凝血功能异常,于术后第6 d因失血、心功能衰竭死亡。结论存在丰富侧支血管形成的重症法洛氏四联症病人,外科矫正术前、术中在造影引导下用KMG微球介入栓塞体肺侧支血管,可减少因手术视野暴露限制,术中结扎体肺侧支血管困难;简化手术过程、提高手术成功率。Objective To demonstrate the feasibility of combined KMG microballoons embolization and surgical treatment in patients with tetralogy of Fallot.Methods From Feb.2004 to Jan.2008,nine patients were given transcatheter aortopulmonary collateral vessel embolization and cardiac surgical correction.Results 25 aortopulmonary collateral vessels were confirmed by angiography,20 of which（80%） were embolized with 12 bottles of KMG microballoons.Arterial pressure kept stable during extracorporeal circulation.Blood flow from collateral vessels was low and operation field was clear and operating time shortened.8 patients recovered completely and 1 patient whose blood congulation disfunction died of heart failure 6 days later.Conclusion Embolization with KMG microballoons before or during surgical correction is an important rescue measurement to simplifies surgical procedure and improve the outcome.

关 键 词：法洛氏四联症 海藻酸钠(KMG)微球 治疗性 栓塞 心血管外科手术方法 

分 类 号：R654.2[医药卫生—外科学]