室间隔缺损介入封堵术对三尖瓣的影响  

Influence of transcatheter closure of three cusp VSD occlusion

作　　者：高招波[1] 

机构地区：[1]江西省南昌市第一医院心血管科,330006

出　　处：《中国医疗前沿》2013年第19期4-5,共2页China Healthcare Innovation

基　　金：江西省科技支撑计划项目(编号:1229)

摘　　要：目的探讨室间隔缺损介入封堵术对三尖瓣的影响。方法对2012年1月-2013年3月我院203例符合介封堵术适应症的腹部室间隔缺损患者行介入治疗,依据术前三尖瓣反流程度及其是否伴有肺动脉高压,分别进行术前和术后即刻、3d、1个月、3个月和6个月行超声心动图检查,观察三尖瓣受损情况,分析轻、中和重度三尖瓣反流发生比例情况。结果 165例成功实施介入手术患者中,1例(0.61%)重度三尖瓣反流;中度(2.42%)4例;轻度16例(9.7%)。观察期末总的三尖瓣反流比例为4.85%。结论对室间隔缺损介入封堵发生三尖瓣反流的原因或与封堵器磨损腱索、导管损伤腱索和输送杆损伤腱索有关,建议在行介入治疗时严格把握手术适应症,在操作过程中小心操作,按规范操作,同时还要密切注意室间隔缺损周围组织结构及形态,以减少三尖瓣反流发生。Objective To investigate the transcatheter occlusion of ventricular septal defect on the effect of tricuspid regurgitation. Methods 203 cases with dielectric closure indications of abdominal ventricular septal defect were treated with interventional therapy on 2011 January to 2013 March in our hospital, according to preoperative three tricuspid regurgitation severity and is associated with pulmonary arterial hypertension, were performed before and after surgery immediately, 3D, 1 months, 3 months and 6 months the echocardiographic examination, observation of three tricuspid valve damage, statistical analysis of light, moderate and severe tricuspid regurgitation occurred in three the proportion of cases. Results 165 cases of successful implementation of patient access operation, 1 cases（0.61%） and three severe tricuspid regurgitation; moderate（2.42%） of 4 cases of mild in 16 cases（9.7%）. Observation of the final three tricuspid total reflux ratio of 4.85%. Conclusion In transcatheter closure of ventricular septal defect causes three tricuspid regurgitation or occluder wear tendons, duct injury tendons and conveying rod damage tendons, suggested in the interventional therapy of strict grasp the operation indications, careful manipulation during operation, according to the standard operation, at the same time, pay close attention to structure and morphology ventricular septal defect the surrounding tissue to reduce three, tricuspid regurgitation occurs.

关 键 词：室间隔缺损 三尖瓣 影响 

分 类 号：R654[医药卫生—外科学]