经导管封堵室间隔缺损术后传导阻滞效果观察  

Follow-up results of heart conduct block after transcatheter closure of ventricular septal defect surgery

作　　者：钟庆华 张智伟[2] 方胜先 钱明阳[2] 谢育梅[2] 王树水[2] 

机构地区：[1]深圳龙岗中心医院心血管内科,518116 [2]广东省人民医院广东省心血管研究所心血管儿科,广州市510080

出　　处：《实用医学杂志》2015年第9期1472-1474,共3页The Journal of Practical Medicine

基　　金：国家"十二五"科技支撑计划项目(编号:2011BA111B22)

摘　　要：目的：探讨室间隔缺损经导管封堵术后传导阻滞的发生率及危险因素。方法：回顾性分析1069例室间隔缺损封堵患者的临床随访资料。采用多因素Logistic 回归分析术后发生传导阻滞的危险因素。结果：随访中位时间2．2（1～4．16）年。术后早期出现传导阻滞219例（20．5％），严重传导阻滞35例（3．3％）。随访期间，出现迟发传导阻滞43例（4．0％），其中完全性房室传导阻滞4例（0．4％）。多因素Logistic回归分析显示：使用偏心型封堵器、手术时间长、使用进口封堵器是术后早期出现严重房室传导阻滞的危险因素；使用小腰大边型封堵器是迟发传导阻滞的危险因素。结论：室间隔缺损经导管封堵术后早期传导阻滞常见，多为轻微可逆。而迟发严重房室传导阻滞少见。行经导管封堵术的室间隔缺损操作时间不宜过长，尽可能选择对称型封堵器。Objective To study the prevalence and risk factors of heart conduct block after transcatheter closure of ventricular septal defect （VSD）surgery. Methods A total of 1 069 cases underwent transcatheter closure VSD were retrospectively analyzed. The risk factors were assessed by multivariable logistical analysis. Results The median follow-up time was 2.2 （1 to 4.16） years. The early post-procedure heart conduct block was 20.5 %（219 cases）, and 35 cases underwent severe conduct block （3.3%）. During the follow-up, there were 43 late onset heart conduct block （4.0%）, including 4 （0.4%） complete atrioventricular block. Multivariable logistic analysis showed that implanted of asymmetrical occluder from foreign company was the risks factors for early onset severe conduct block, with longer procedure time. Placement of thin-waist-big-side occluder were risk factor for the late onset conduct block. Conclusions Heart conduct block after transcatheter closure VSD is common , light and recovery. The late onset severe conduct block is minor. Symmetrical occluder should be chosen in transcatheter closure VSD if possible.

关 键 词：传导阻滞 室间隔缺损 心脏导管插入术 

分 类 号：R654.2[医药卫生—外科学]