先天性心脏病介入治疗严重并发症的分析及处理  

Analysis and management of severe complications induced by interventional therapy for congenital heart disease

作　　者：刘志平[1] 朱宪明[1] 李淑珍[1] 郭俊晓[1] 王坚[1] 赵龙[1] 张玉龙[1] 李育敏[1] 任杰[1] 高荣[1] 王敏[1] 

机构地区：[1]内蒙古医科大学附属医院心脏大血管外科,010059

出　　处：《心肺血管病杂志》2015年第8期620-621,共2页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨先天性心脏病(先心病)介入治疗中和治疗后严重并发症的发生率、原因及防治措施。方法:自2004年1月至2014年9月,我院共有507例先心病患者施行介入治疗。将其中发生的需经急诊介入或外科手术处理的并发症定义为严重并发症。结果:507例先心病患者中发生封堵伞脱落5例。介入术中及术后严重并发症封堵伞脱落总发生率为1.0%(5/507),其中房间隔缺损(ASD)组的并发症为封堵伞脱落4例,0.1%(4/276);主动脉窦瘤破裂封堵术组,封堵伞脱落1例:为33.3%(1/3)。紧急开胸手术占1.0%(5/507)。结论:先心病介入治疗的严重并发症发生率低,但应警惕封堵伞脱落,一经确诊,需积极外科手术治疗。Objective ：To analyze the incidence, causes, prevention and treatment of severe complications developing during and after interventional therapy for congenital heart disease （CHD）. Methods：From January 2014 to September 2014,507 patients with CHD received interventional therapy in our hospital. Severe complications were defined as the conditions needing emergent interventional or surgical management during or after interventional therapy for CHD. Results： Occluder detachment occurred in 5 patients, acute pericardial tamponade in 3 patients and the rupture of left atrium roof caused by the delivery sheath in 1. The overall com- plication rate was 1.8% （9/507） ： 0. 2% （5/276） post atrial septal defect （ASD） occlusion, 1.8% （3/17） post patent foramen ovale （PFO） occlusion, and 33.3% （ 1/3 ） post occlusion for the rupture of aortic sinus aneu- rysm. No severe complication occurred in other procedures. Conclusion：The severe complication rate of interventional therapy for CHD are low, but occluder detachment and acute pericardial tamponade should be paid more attention and require immediate pericardial drainage or emergent surgery.

关 键 词：先天性心脏病 介入 并发症 封堵伞脱落 心脏外科手术 

分 类 号：R54[医药卫生—心血管疾病]