经胸二维超声心动图引导儿童房间隔缺损经皮封堵治疗术  

Transcatheter closure of atrial septal defect under the guidance of two-dimensional transthoracic echocardiography

作　　者：逄坤静[1] 王浩[1] 孟红[1] 赵星[1] 欧阳文斌[2] 张凤文[2] 张大伟[2] 刘垚[2] 潘湘斌[2] 

机构地区：[1]北京,中国医学科学院北京协和医学院阜外心血管病医院超声科100037 [2]北京,中国医学科学院北京协和医学院阜外心血管病医院心外科100037

出　　处：《中华超声影像学杂志》2014年第7期573-576,共4页Chinese Journal of Ultrasonography

摘　　要：目的探讨经胸二维超声引导下经皮房间隔缺损封堵术的可行性。方法超声检查入选单纯房间隔缺损患儿40例，房间隔缺损大小（11．37±3．61）mm。单纯采用经胸超声引导，于局麻或基础麻醉下，经股静脉穿刺封堵房间隔缺损。超声实时监测封堵全过程，评估封堵效果。术后1个月、3个月随访，经胸超声复查封堵效果。结果37例患儿在普通经胸二维超声监测引导下封堵器置入成功，操作过程简易、安全。3例患儿因经胸超声图像显示不清，于术中行气管插管后，改为经食管超声引导下封堵成功。术后1个月及3个月随访，未发现瓣膜损伤、心包积液、残余分流、外周血管损伤等介入并发症。结论经胸超声引导可以完成儿童房间隔缺损经皮封堵术，无需使用大型造影设备，而且避免了经食管检查的痛苦及风险，具有广泛的临床应用前景。Objective To explore the feasibility of transcatheter closure of atrial septal defect （ASD） under the guidance of two-dimensional transthoracic echocardiography （2D-TTE）. Methods The study involved 40 patients diagnosed as ASD by TTE.The mean age of the patients was （7.25±3.96）years, and the mean weights was （22.32±8.30）kg.The mean diameters of ASD was （11.37±3.61）ram. The patients underwent local or basal anesthesia.The transcatheter closure of ASD were performed under the guidance of 2D-TTE.The patients underwent follow-up echocardiography at one and three months after surgery.Results Closure devices were successfully implanted in 37 patients under 2D-TTE guidance. The procedure was simply and safe. In 3 patients, the procedure was monitored by transesophageal echocardiography （TEE） after tracheal intubation,instead of 2D-TTE,because the 2D-TTE images were not clear.During the followup,no severe complication such as valvular injury, pericardial effusion, residual shunt, and peripheral vascular injury occurred. Conclusions Transcatheter closure of ASD under 2D-TTE guidance provides a feasibility method which not only overcome the damage of radiation, but also avoided pains and risks of TEE.The procedure has a broad clinic prospects.

关 键 词：超声心动描记术 房间隔缺损 封堵术 

分 类 号：R725.4[医药卫生—儿科]