经皮球囊肺动脉瓣成形术联合房间隔缺损封堵器闭合缺损治疗房间隔缺损合并肺动脉瓣狭窄的疗效  

The curative effect of pulmonary valve stenosis after percutaneous balloon pulmonary valvuloplasty combined with atrial septal defect occluder defect treatment of atrial septal defect

作　　者：马星星[1] 高智耀[1] 张义和[1] MA Xing-xing;GAO Zhi-yao;ZHANG Yi-he(Cardiovascular Medical Center, Yan'an University Affilated Hospital, Yan'an Shaanxi 716000, China)

机构地区：[1]延安大学附属医院心脏血管医学中心,陕西延安716000

出　　处：《临床和实验医学杂志》2018年第5期509-512,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨经皮球囊肺动脉瓣成形术(PBPV)联合房间隔缺损封堵器闭合缺损治疗房间隔缺损(ASD)合并肺动脉瓣狭窄(PS)的疗效。方法回顾性选取2013年1月至2016年1月收治的38例ASD合并PS患者,完善术前检查,同期行PBPV治疗PS和AmpIatzer封堵器介入治疗ASD。记录比较每例患者的术前及术后肺动脉瓣跨瓣压差(PG)和最大流速(Vmax),患者于术后立刻行经胸超声心动图(TTE)观察房间隔有无残余分流,术后1个月、3个月、6个月后复查TTE,观察疗效。结果 38例患者同期行PBPV术及ASD介入封堵治疗均获得成功。与PBPV术前比较,术后导管测量PG、右心室舒张末压、超声测量PG、Vmax均显著降低,差异有统计学意义(P<0.05)。所有患者于术后即刻TTE显示ASD封堵完全,封堵器位置良好,未对毗邻组织产生影响,未见房间隔有残余分流。术后1个月、3个月、6个月后复查TTE,未见封堵器移位,未见其他并发症的发生,房间隔未见残余分流,18例继发右室肥厚患者恢复至正常水平。结论在术前检查对患者ASD的直径大小、位置、其他合并症状及缺损边缘的情况有详细了解的前提下,PBPV联合ASD封堵器闭合缺损治疗ASD合并PS是有效而且安全的,能取得良好的临床效果。Objective To investigate the effect of percutaneous balloon pulmonary valvuloplasty(PBPV)combined with atrial septal defect occluder closure defect in the treatment of atrial septal defect(ASD)combined with pulmonary stenosis(PS).Methods From January2013to January2016,38cases of ASD patients with PS,the preoperative examination were improved,underwent PBPV treatment PS and AmpIatzer occluder ASD.Before and after the operation,the pulmonary valve transvalvular pressure difference were recorded and compared,immediately TTE were performed after surgery to observe atrial septal without residual shunt,and after1months,3months and6months,TTE was performed.Results38cases of patients underwent PBPV surgery and ASD interventional therapy were successful.Compared with preoperative PBPV,postoperative catheter measurement of PG,right ventricular end-diastolic pressure,ultrasound measured PG,Vmax were significantly reduced,the difference was statistically significant(P<0.05).All patients in the immediate postoperative TTE showed ASD complete closure,occluder in good position,not on the adjacent tissue influence,no residual shunt atrial septal surgery.After1months,3months and6months TTE were checked,no occluder shift,no other complications of atrial septal,no residual shunt,18secondary right ventricular hypertrophy patients returned to normal level,effective treatment.Conclusion After a detailed understanding of examination of patients with ASD in diameter,position and other associated symptoms and the defect edge in the preoperative condition,PBPV combined with ASD occluder defect treatment of ASD combined with PS is effective and safe,and can achieve good clinical results.

关 键 词：房间隔缺损 肺动脉瓣狭窄 介入治疗 经皮球囊肺动脉瓣成形术 房间隔缺损封堵器 

分 类 号：R541.1[医药卫生—心血管疾病]