国产封堵器在治疗先天性心脏病的临床疗效分析  

Clinical efficacy of domestic occluder devices on treating Congenital heart disease

作　　者：胡楝[1] 曹勇[1] 陈波[1] 余观水[1] 韦国雄[1] 程华森[1] HU Lian;CAO Yong;CHEN Bo;YU Guan-shiu;WEI Guo-xiong;CHENG Hua-sen(Department of Cardiovascular Surgery,Gaozhou People's Hospital,Gaozhou 525200,China)

机构地区：[1]高州市人民医院心血管外科,广东省高州市525200

出　　处：《中国心血管病研究》2019年第2期181-183,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的 总结国产封堵器经皮和经胸途径治疗先天性心脏病的临床疗效。方法 回顾性分析我院2013年1月至2017年12月在X线透视下或单纯超声心动图引导下采用经皮穿刺股静脉或股动静脉法,或者食管超声心动图监测下经胸小切口行先天性心脏病封堵1186例,其中经皮X线下封堵1081例、经皮单纯超声引导下封堵42例、经胸封堵63例;其中动脉导管未闭( patent ductus arteriole,PDA)426例、房间隔缺损(atrial septal defect,ASD)363例、室间隔缺损(ventricular septal defect,VSD)348例、卵圆孔未闭11例、房间隔缺损合并室间隔缺损9例、房间隔缺损合并动脉导管未闭6例、房间隔缺损合并肺动脉瓣狭窄(pulmonary stenosis,PS)12例、动脉导管未闭合并肺动脉瓣狭窄8例、主肺动脉侧支封堵3例[经胸封堵66例改为63例,PDA443例改为426例]。结果 全组病例成功率98.2%(1165/1186),无死亡病例。随访1~36个月,术后第1、3、6、12个月及术后每年常规行超声心动图及心电图检查。术后第1、6、12个月的随访率分别为 92.9%(1102/1186)、84.1%(998/1186)、70.5%(836/1186)。超声心动图提示少量残余分流(<3 mm)18例;三尖瓣少量反流33例,中量反流5例;主动脉瓣轻度反流5例,中度反流1例;心律失常Ⅲ°房室传导阻滞(Avionics Bulletin,AVB[房室传导阻滞(Avionics Bulletin,AVB)])1 例,Ⅱ°AVB 3例,完全性左束支3例,交界性心动过速3例,交界性逸搏2例。结论 国产封堵器在先天性心脏病封堵治疗中具有成功率高、创伤小、并发症低、操作容易、疗效确切、恢复快等特点,是治疗先天性心脏病的理想方法。Objective To evaluate the clinical effectiveness of domestic occluder devices on treating congenital heart diseases(CHD) through transparent or transatlantic closure. Methods To retrospectively analyze from January 2013 to December 2017. There were 1186 patients under X-ray fluoroscopy, by percutaneous puncture femoral arteriovenous method or and esophagus echocardiography monitoring line of CHD devices closure blocking the chest be small incision under the treatment, including percutaneous transcendent closure under X-ray 1078 cases, under ultrasound 42 cases, and transatlantic closure 63 cases. All patients were occluded with the domestic occluder including 426 patients with patent ductus arteriole(PDA), 363 patients with atrial septal defect(ASD), 348 patients with ventricular septal defect(VSD), 11 patients with patent foramen ovule(PFO), 9 patients with ASD+VSD, 6 patients with ASD+PDA, 12 patients with ASD+ pulmonary stenosis(PS), 3 patients with ventricular septal perforation after myocardial infarction, 3 patients with main pulmonary artery collateral occlusion. Results The success rates 98.2%(1165/1186), and no death cases. Follow up on for 1-36 months. Echocardiography and electrocardiogram(ECG) were regularly performed in the first month, 6 months and 12 months after operation. The follow-up rates of the first month, the sixth month and the 12th month were 92.9%(1102/1186)、84.1%(998/1186) 70.5%(836/1186). 18 cases have a small residual shunt (<3 mm), 33 cases with tricuspid regurgitation. There were five cases of moderate tricuspid regurgitation. 5 cases of mild aortic valve regurgitation, white 1 case moderate regurgitation, 1 cases of III degree Avionics Bulletin(AVB), 3 cases of II degree (AVB),3 cases of complete left bundle branch, 3 cases of borderline tachycardia and 2 cases of junctions escape beats. Conclusion Domestic occluder has a high success rate, small trauma, complication is low, the operation is simple, the curative effect, rapid recovery and other characteristics, are an ideal metho

关 键 词：国产封堵器 经皮和经胸途径 先天性心脏病 

分 类 号：R654.2[医药卫生—外科学]