先天性心脏病介入治疗严重并发症的分析  

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

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

机构地区：[1]内蒙古医科大学附属医院心脏大血管外科,内蒙古呼和浩特市010050

出　　处：《中国心血管病研究》2015年第12期1144-1146,共3页Chinese Journal of Cardiovascular Research

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，并分析其发生率、发生原因及防治措施。结果507例先心病患者中发生封堵伞脱落5例、急性心包填塞3例、输送鞘管至左房顶破裂1例。介入术中及术后严重并发症总发生率为1．77％（9／507）。其中房间隔缺损（ASD）组的并发症为0．18％（5／276），包括封堵伞脱落4例、急性心包填塞1例；卵圆孔未闭（PFO）组的并发症为1．76％（3／17），包括急性心包填塞2例、输送鞘管至左房顶破裂1例；主动脉窦瘤破裂封堵术组为33．33％（1／3），为1例封堵伞脱落。紧急开胸手术占1．38％（7／507），在介入手术室心包置管引流占0．39％（2／507）。其余动脉导管未闭PDA组118例、室阃隔缺损（VSD）组78例、肺动脉瓣球囊成形术组11例、肺动静脉畸形栓塞术2例、冠状动脉瘘栓塞术组2例，均无严重并发症发生。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、急性心包填塞等严重并发症发生，一经确诊，需积极心包引流或外科手术治疗。Objective To analyze the incidence, causes, prevention and treatment of severe complica- tions developing during and after interventional therapy for congenital heart disease （CHD）. Methods From Jan- uary 2014 to September 2014, 507 patients with CHD received interventional therapy in our hospital. Severe com- plications were defined as the conditions needing emergent interventional or surgical management during or after in- terventional 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 complication rate was 1.77% （9/507）： including 0.18% （5/276） in atrial septal defect （ASD） occlusion group, 1.76% （3/17 ） in patent foramen ovale （PFO） occlusion group, and 33.3%（1/3） in occlusion for the rupture of aortic sinus a- neurysm. No severe complication occurred in other procedures. Conclusion The severe complication rate of inter- ventional 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 心包填塞 心脏外科手术 

分 类 号：R654.2[医药卫生—外科学]