经皮室间隔心肌化学消融治疗肥厚梗阻性心肌病16例观察  

The observation of the curative effect of percutaneous transluminal septal myocardial ablation in patients with hypertrophic obstructive cardiomyopathy

作　　者：颜景涛[1] 杨文灿[1] 游涛[1] 

机构地区：[1]新汶矿业集团中心医院心内科,山东省新泰市271233

出　　处：《中国心血管病研究》2013年第8期592-594,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨经皮室间隔心肌化学消融（胛SMA）方法治疗肥厚性心肌病（HOCM）的疗效。方法16例肥厚型梗阻性心肌病患者，男性12例，女性4例，平均年龄（35．8＋11，O）岁；均在术前接受过13受体阻滞剂和（或）钙拮抗剂治疗效果不佳。确定靶血管后，向球囊导管中心腔内注入无水乙醇，同时密切观察患者的心电图及LVOTG的变化。所有患者术后均复查超声心动图，随访观察6个月。结果16例患者中13例消融第一间隔支，3例消融第二间隔支，2例同时消融第一、二间隔支。无严重并发症（高度房室传导阻滞）发生。术后2例心脏杂音完全消失，9例心脏杂音减轻1～2级。术后超声心动图均提示原先肥厚的室间隔心肌变薄，搏动减弱，LVOTG下降，SAM现象消失。结论PTSMA是通过PTCA技术经导管向供应肥厚室间隔心肌的间隔支动脉内注入无水乙醇引起局灶性心肌梗死以达到缓解左室流出道梗阻的一种新技术，是一种治疗HOCM的有效方法。Objective To observe the curative effect of PTSMA in HOCM patients. Methods 16 HOCM patients（ 12 men, 4 women, mean age 35.8：1：11 years ）.They had all received drug therapy such as 13-bloekers and/ or calcium antagonists with less therapeutic efficacy, absolute alcohol was injected into the septal branch through the central lumen of balloon catheter. ECG and LVOTG should be observed closely at the same time. Each of them will take an echocardiogram after the procedure and will be followed-up for six months. Results 13 of them were per- formed in the first septal braneh, 3 were in the second septal braneh, the remaining 2 cases were peformed in both vessels. The cardiac murmur were disappeared eompletely in 2 cases, 9 were attenuated I-II class than before.After the procedure, the echocardiogram showed that the hypertrophic myocardium of ventricular septum was thinner and weaken, and the LOVTG was decreased, the SAM phenomenon was disappeared. Conclusion PTSMA is a new kind of technology, which is using the technique of PTCA , can cause focal myocardial infarction by injecting the absolute alcohol into the septal branch. It seemd PTSMA is an effective way to treat HOCM.

关 键 词：肥厚型梗阻性心肌病 经皮室间隔心肌化学消融术 

分 类 号：R589[医药卫生—内分泌]