经皮室间隔心肌化学消融术治疗老年梗阻性肥厚型心肌病临床疗效及安全性  

Percutaneous transluminal septal myocardial chemical ablation for the treatment of hypertrophic obstructive cardiomyopathy in aged patients: its clinical efficacy and safety

作　　者：阚通 郭俊[1] 陈亮[1] 崔玲[1] 储国俊 章伟[1] 赵仙先[1] 秦永文[1] 

机构地区：[1]第二军医大学附属长海医院心血管内科,上海200433

出　　处：《介入放射学杂志》2015年第11期946-949,共4页Journal of Interventional Radiology

摘　　要：目的探讨经皮室间隔心肌化学消融术(PTSMA)治疗梗阻性肥厚型心肌病(HOCM)患者的临床疗效及安全性。方法选择2010年1月至2014年12月在第二军医大学附属长海医院接受PTSMA术治疗的HOCM患者共68例,分为老年患者组(观察组,n=30)和非老年患者组(对照组,n=38)。对两组患者临床资料、血流动力学参数及术后并发症发生情况进行分析。结果观察组患者术后有创左心室流出道压差(LVOTPG)值(22.57±20.41)mm Hg与术前(90.43±37.62)mm Hg相比明显下降(P<0.001),对照组患者术后有创LVOTPG值(21.34±22.20)mm Hg与术前(84.82±34.59)mm Hg相比明显下降(P<0.001),两组患者术前术后有创LVOTPG变化值(67.87±39.97)mm Hg对63.47±31.62)mm Hg差异无明显统计学意义(P=0.614)。观察组和对照组患者术后总体并发症发生率(36.67%对26.32%)差异无统计学意义(P=0.359),严重并发症(完全性房室传导阻滞、急性左心功能衰竭)发生率(13.33%对0%,P=0.072)差异无统计学意义(P=0.072)。结论 PTSMA术治疗老年HOCM患者是安全有效的。Objective To discuss the efficacy and safety of percutaneous transluminal septal myocardial ablation （PTSMA） in treating aged patients with hypertrophic obstructive cardiomyopathy （HOCM）. Methods A total of 68 HOCM patients, who received PTSMA at the Affiliated Changhai Hospital of Second Military Medical University during the period from January 2010 to December 2014, were enrolled in this study. The patients were divided into the observation group （n=30） and the control group （n=38）. The clinical data, the hemodynamic parameters and complications after PTSMA were recorded, and the results of the two groups were compared. Results In the observation group, the postoperative left ventricular outflow tract pressure gradient （LVOTPG） was （22.57±20.41） mmHg, which was significantly lower than the preoperative （90.43±37.62） mmHg （P〈0.001）. In the control group, the postoperative LVOTPG was （21.34± 22.20） mmHg, which was remarkably decreased when compared to the preoperative （84.82±34.59） mmHg （P〈0.001）. The changing values of preoperative and postoperative LVOTPG of the observation group and the control group were （67.87±39.97） mmHg and （63.47±31.62） mmHg respectively, and the differences between the two groups were not statistically significant （P=0.614）. The total incidences of postoperative complication of the observation group and the control group were 36.67% and 26.32% respectively, and the differences between the two groups were not statistically significant （P=0.359）. The incidences of severe complication, such as complete atrioventricular block and acute left heart failure, of the observation group and the control group were 13.33% and 0% respectively, and the differences between the two groups were not significant （P=0.072）. Conclusion In treating aged patients with HOCM, PTSMA is safe and effective.

关 键 词：梗阻性肥厚型心肌病 经皮室间隔心肌化学消融术 老年 

分 类 号：R542.2[医药卫生—心血管疾病]