先天性心脏病室间隔缺损介入治疗前后左心及血流动力学指标变化  

Transcatheterizition of ventricular septal with congenital heart disease: changes of left ventricle function and hemodynamics

作　　者：刘新波[1] 李有金[1] 陈家华[1] 张亚政[1] 陈永祥[1] 

机构地区：[1]宁夏自治区人民医院心胸外科,宁夏银川750021

出　　处：《宁夏医学杂志》2012年第5期421-423,共3页Ningxia Medical Journal

基　　金：宁夏自然科学基金资助项目(NZ10170)

摘　　要：目的研究先天性心脏病室间隔缺损(CHD-VSD)介入治疗前后左心功能及血流动力学指标的变化。方法 43例CHD-VSD患者,术前经胸片、超声心动图诊断,术前及术后3 d、1、6个月、1年经超声心动图检查左房前后径(LA)、左室舒张末期前后径(LVEDD)、左室收缩末期前后径(LVESD)、主动脉内径(AOD)、肺动脉压力(PASP)、每分输出量(CO)、每搏输出量(SV)、左室射血分数(EF)、左室短轴收缩率(FS)。结果 40例均成功置入封堵器,1例术后第3 d出现封堵器脱落,改行手术治疗。术后随访所有患者封堵器位置、形态良好,LA、LVEDD、LVESD、LAD较术前明显下降(P<0.01),AOD术前术后无明显变化;PASP术后3 d明显下降(P<0.01),术后1、6个月、1年较术后3 d下降(P<0.01),术后1年较术后6个月下降(P<0.05)。CO术后3 d较术前明显下降(P<0.05),CO术后1、6个月较术前明显下降(P<0.05),术后1年继续下降(P<0.01)。SV术后3 d较术前明显下降(P<0.05),术后3 d EF、FS无明显变化,术后1、6个月、1年EF、FS较术前显著下降(P<0.05)。结论介入治疗CHD-VSD操作简单,安全有效,患者术后左心功能及血流动力学改善明显。Objective To investigate the changes of left ventricle function and hemodynamics after transcatheterizition of ventricular septal with congenital heart disease.Methods 43 patients with CHD-VSD were diagnosed by physical examination,chest X-ray and transthoracic echocardiography.Transthoracic echocardiography was implied to measure the left atrial diameter（LA）,left ventricle end-diastole diameter（LVEDD）,left ventricle end-systole diameter（LVESD）,artery diameter（AOD）,pulmonary artery diameter（PD）,pulmonary artery pressure（PASP）,cardiac output（CO）,stroke volume（SV）,ejection fraction（EF）and fraction shortening（FS）at pre-operation and 3-day,1-month,6-months and 1-year after operation.Results 40 patients were implanted occluder;there was one patient with surgical operation after the interventional therapy 3 days because of the occluder dropped.All the occluders located in proper position and there shapes were accurate in follow-up.LA,LVEDD and LVESD decreased significantly（P〈0.001）.AOD did not change markedly,PASP was decreased significantly（P〈0.001）.EF and FS did not change remarkably 3days post-operation,but reduced markedly after one month,six months and one year.Conclusion Transcatheterizition of CHD-VSD is effective and safe.It can improve the left ventricle function and hemodynamics.

关 键 词：先天性心脏病 介入治疗 左心功能 血流动力学 

分 类 号：R541.1[医药卫生—心血管疾病]