边疆地区少数民族室间隔缺损患者膜部瘤形态及介入封堵治疗分析  

Analysis on the morphology and transcatheter closure of the aneurysm of membranous ventricular septal defect in ethnic minorities from border area

作　　者：孟越之 沈叶佳 吴晓霞[2] 陆强 刘英[1] 沈志奇[1] 李红[1] 马东星[1] 

机构地区：[1]武警总医院心血管内科,北京100039 [2]武警总医院超声科,北京100039 [3]良乡医院心血管内科,北京102401

出　　处：《中华灾害救援医学》2016年第2期78-80,共3页Chinese Journal of Disaster Medicine

摘　　要：目的探讨边疆少数民族室间隔缺损(ventricular septal defect,VSD)患者膜部瘤的造影形态特点并总结其单中心介入封堵治疗的策略与技巧。方法对2005-08至2015-05在武警某部三甲医院心血管疾病介入治疗中心行介入治疗的356例来自新疆、西藏、云南、青海、内蒙古膜部瘤型VSD少数民族患者的临床资料进行回顾性分析。结果依据左心室造影结果,356例膜部瘤分为四型:208例菜花型(58.4%),71例囊袋型(19.9%),42例漏斗型(11.8%),35例弯管型(9.8%)。337例封堵成功,成功率约94.7%。19例未成功转外科治疗。根据年龄将337例介入封堵治疗成功者分为两组,两组左室舒张末期内径(left ventricular end-diastolic dimension,LVEDD)与封堵前相比均显著缩小(t=3.077,P=0.005;t=2.257,P=0.042)。术后随访6个月无迟发性心律失常、瓣膜受损、卒中或死亡事件。结论边疆少数民族VSD患者的膜部瘤形态以菜花型为主,应用国产室间隔封堵器介入封堵治疗安全有效,成功率高。Objective To explore the morphological characteristics of the aneurysm of membranous ventricular septal defect （VSD） in ethnic minorities from border area, and to summarize the strategies and skills of monocentric transcatheter closure treatment. Methods Clinical data of 356 ethnic minorities patients from border areas of Xinjiang, Tibet, Yunnan, Qinghai and Inner Mongolia with aneurysm of membranous VSD who underwent transcatheter closure treatment between Aug 2005 and May 2015 at the cardiovascular diseases intervention center of a top three hospital of the armed police forces were analyzed retrospectively. Results The aneurysm of membranous VSD were classified into 4 types by left ventriculography： cauliflower type 58.4% （208 cases）, sack type 19.9% （71 cases）, funnel type 11.8% （42 cases） and ductus type 9.8% （35 cases）. 337 cases were successfully cured, the successful rate was 94.7%. 19 cases were failed, then turned to surgical treatment. 337 patients with successful transcatheter closure were divided into two groups according to age. Changes of left ventricular end-diastolic dimension （LVEDD） in two groups both shrinked significantly （t=3.077, P=0.005; t=2.257, P=0.042）. 6-month follow-up showed no delayed arrhythmia, valve damage, stroke or death event. Conclusions The cauliflower type is the most common morphology of the aneurysm of membranous VSD in ethnic minorities from border area. Transcatheter closure with a domestic occluder is safe and effective.

关 键 词：室间隔缺损 膜部瘤 介入性 

分 类 号：R541.1[医药卫生—心血管疾病]