经导管封堵治疗卵圆孔未闭并发隐匿性脑卒中或短暂性脑缺血发作的临床效果  

Clinical effect of transcatheter closure of patent foramen ovale with occult stroke or transient ischemic attack

作　　者：任明明[1] 韩振[1] 吴军[2] 胡俊[2] 郭雨竹 黄磊[1] 许志锋[1] 欧阳春[1] 符鹏程 Ren Mingming;Han Zhen;Wu Jun(Cardiovascular surgery,Peking University Shenzhen Hospital,Shenzhen Guangdong518000;不详)

机构地区：[1]广东省深圳市北京大学深圳医院心血管外科,518000 [2]广东省深圳市北京大学深圳医院神经内科,518000 [3]深圳市龙华区中心医院

出　　处：《卒中与神经疾病》2020年第2期152-155,160,共5页Stroke and Nervous Diseases

基　　金：广东省哲学社会科学“十二五”规划项目(2017B060500027)。

摘　　要：目的探讨经导管封堵治疗卵圆孔未闭并发隐匿性脑卒中或短暂性脑缺血发作的临床效果。方法选取本院2016年2月-2018年8月收治的120例卵圆孔未闭并发隐匿性脑卒中或短暂性脑缺血发作患者为研究对象,分为对照组和实验组,每组各60例,对照组患者采用阿司匹林进行治疗,实验组患者进行经导管封堵治疗,观察2组患者的治疗效果、治疗前、治疗6个月后的临床指标水平变化、治疗前、治疗6个月后的血栓弹力图(TEG)指标水平变化以及治疗6个月后的并发症发生率和脑缺血事件复发率。结果实验组的治疗效果明显好于对照组(P<0.05);治疗6个月后实验组的射血分数、左室舒张末内径、心率和左室收缩末内径均高于对照组(P<0.05);治疗6个月后实验组的α-角和MA值明显低于对照组,AA途径诱导的血小板控制率明显高于对照组(P<0.05);治疗6个月后实验组的并发症发生率和脑缺血事件复发率明显低于对照组(P<0.05)。结论经导管封堵对卵圆孔未闭并发隐匿性脑卒中或短暂性脑缺血发作的临床效果较好,可以提高患者的心功能,明显降低血小板聚集,降低患者的脑缺血事件复发率和并发症发生率。Objective To explore the clinical effect of transcatheter closure of patent foramen ovale complicated with occult stroke or transient ischemic attack.Methods 120 patients with patent foramen ovale complicated with occult stroke or transient ischemic attack were Selected as the study subjects in our hospital,from February 2016 to August 2018.They were divided into control group and experimental group.60 patients in each group were treated with aspirin.The experimental group was treated with transcatheter closure therapy.The therapeutic effect,clinical parameters before and after treatment,changes of thromboelastogram(TEG)parameters before and after treatment,complications and recurrence rate after 3 months of treatment were observed.Results The results showed that the treatment effect of the experimental group was better than that of the control group;after treatment,the ejection fraction,left ventricular end diastolic diameter and left ventricular end systolic diameter of the experimental group were higher than those of the control group.After treatment,the alpha-angle and MA values of the experimental group were significantly lower than those of the control group,and the platelet control rate induced by AA pathway was significantly higher than that of the control group.The incidence of complications and recurrence in the experimental group were significantly lower than those in the control group(P<0.05).Conclusion Transcatheter occlusion of patent foramen ovale complicated with occult stroke or transient ischemic attack had a good clinical effect.It could improve the therapeutic effect of patients,improve their cardiac function,significantly reduce platelet aggregation,reduce the recurrence rate and complications of patients.

关 键 词：经导管封堵 卵圆孔未闭 隐匿性脑卒中 短暂性脑缺血发作 临床效果 

分 类 号：R743[医药卫生—神经病学与精神病学]