两种不同封堵器对不明原因脑卒中合并大量右向左分流患者卵圆孔未闭的疗效对比  

Comparison of Two Occlusion Devices for Treating Cryptogenic Stroke Patients Combining Patent Foramen Ovale and Large Right to Left Shunt

作　　者：刘文娟[1] 张玉顺[1] 成革胜[1] 杜亚娟[1] 何璐[1] 王星烨[1] 谢学刚 LIU Wen-juan;ZHANG Yu-shun;CHENG Ge-sheng;DU Ya-juan;HE Lu;WANG Xing-ye;XIE Xue-gang(Department of Structural Heart Disease, The First Affiliated Hospital of Xi＇an Jiaotong University, Xi＇an （710061）, Shaanxi, China)

机构地区：[1]西安交通大学第一附属医院结构性心脏病科,陕西省西安市710061

出　　处：《中国循环杂志》2018年第4期385-389,共5页Chinese Circulation Journal

基　　金：陕西省科技统筹创新工程计划(2014KTCL03-11)

摘　　要：目的:对比两种不同封堵器对不明原因脑卒中(CS)合并大量右向左分流(RLS)患者卵圆孔未闭(PFO)封堵治疗的疗效。方法:2013-05至2016-08期间连续入选CS合并大量RLS的123例PFO患者,应用Cardi-O-fix PFO封堵器(Cardi-O-fix PFO封堵器组,80例)或Amplatzer PFO封堵器(Amplatzer PFO封堵器组,43例)行经皮PFO介入封堵术。所有患者先行影像学检查并经3位经验丰富的神经内科专家明确CS的诊断,然后经胸超声心动图及右心声学造影诊断PFO及大量RLS。回顾患者的基线特征、临床症状、手术及随访数据,观察两种封堵器封堵治疗的疗效。结果:术后两组各有1例发生阵发性心房颤动,Cardi-O-fix PFO封堵器组1例术后出现腹股沟血肿。随访期间两组无复发性脑卒中及死亡事件发生。两组各随访时期残余分流的差异无统计学意义。结论:在预防脑卒中复发方面,PFO介入封堵可为CS伴大量RLS的PFO患者带来获益。Cardi-O-fix PFO封堵器与Amplatzer PFO封堵器在安全性和有效性方面相似。Objectives： To compare the effect of 2 different occlusion devices for treating cryptogenic stroke（CS） patients combining patent foramen ovale（PFO） and large right-to-left shunt（RLS）.Methods： A total of 123 CS patients combining PFO and large RLS treated in our hospital from 2013-05 to 2016-08 were enrolled. All patients received percutaneous PFO interventional closure, based on different occlusion devices, the patients were divided into 2 groups： Cardi-O-fix PFO occluder group, n=80 and Amplatzer PFO occluder group, n=43. CS diagnosis was confirmed by 3 experienced neurologists via medical imaging examination; PFO and large RLS were diagnosed by transthoracic echocardiography and right heart contrast echocardiography. The baseline features, clinical symptoms, operation and follow-up data were reviewed to observe the efficacy of 2 occlusion devices.Results： Each group had 1 patient suffered from paroxysmal atrial fibrillation after the operation; 1 patient in Cardi-O-fix PFO occluder group had inguinal hematoma. No stroke recurrence, no death during follow-up period; the residual shunt was similar between 2 groups.Conclusions： PFO occlusion was beneficial for preventing stroke recurrence in CS patients combining PFO and large RLS. The safety and efficacy were similar in Cardi-O-fix and Amplatzer PFO occlusion devices.

关 键 词：卵圆孔 未闭 卒中 封堵器 

分 类 号：R54[医药卫生—心血管疾病]