食管超声引导下经皮股动脉封堵室间隔缺损的疗效分析  

Efficacy analysis of esophageal ultrasound-guided percutaneous femoral artery closure for ventricular septal defect

作　　者：孙保 程端 李波 贺贵宝 王海峰 阿哈提 伊力亚斯 盛唏 李金鹏 SUN Bao;CHENG Duan;LI Bo;HE Guibao;WANG Haifeng;Ahati;Elias;SHENG Xi;LI Jinpeng(Department of Cardiac Surgery,Xinjiang Cardiac and Neurovascular Disease Hospital,Urumqi,830011,P.R.China;Department of Ultrasound,Xinjiang Cardiac and Neurovascular Disease Hospital,Urumqi,830011,P.R.China)

机构地区：[1]新疆心脑血管病医院心外科,乌鲁木齐830011 [2]新疆心脑血管病医院超声科,乌鲁木齐830011

出　　处：《中国胸心血管外科临床杂志》2021年第12期1471-1475,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的探讨食管超声引导下经皮股动脉封堵室间隔缺损(ventricular septal defect,VSD)的有效性及安全性。方法回顾性分析2017年3月至2019年12月在我院治疗的24例先天性VSD患者的临床资料,其中男6例、女18例,中位年龄12(3~42)岁,体重32(12~91)kg,VSD直径4(3~7)mm,VSD合并房间隔缺损3例。结果 24例患者均在食管超声引导下经皮股动脉完成介入封堵,封堵器位置、形态良好。手术时间45(39~54)min,封堵器腰径7(5~12)mm。使用对称VSD封堵器14例、非对称VSD封堵器8例、肌部封堵器2例;术后2例有少量残余分流,术后3个月复查时分流消失;1例右束支传导阻滞,观察1周后消失。围手术期未见封堵器脱落、心包积液、瓣膜反流等并发症。术后随访时间3~18(9.25±5.04)个月,随访期间均无严重并发症发生。结论食管超声引导下经股动脉封堵VSD操作路径简单、安全性高,避免了放射线及造影剂损伤,相较于传统经皮介入封堵治疗更具有优势。Objective To investigate the effectiveness and safety of esophageal ultrasound-guided percutaneous femoral artery closure of ventricular septal defect(VSD). Methods The clinical data of 24 patients with congenital VSD in our hospital from March 2017 to December 2019 were retrospectively analyzed, including 6 males and 18 females, with a median age of 12(3-42) years, weight of 32(12-91) kg, and VSD diameter of 4(3-7) mm. There were 3 patients with VSD combined with atrial septal defect. Results Twenty-four patients successfully underwent interventional closure of percutaneous femoral artery under esophageal ultrasound guidance, and the position and shape of the occluders were good. The operation time was 45(39-54) min, and the waist size of the occluders was 7(5-12) mm. Among the patients, 14 patients used symmetric ventricular occlusion devices, 8 patients used asymmetric ventricular occlusion devices, and 2 patients used ventricular occlusion muscle occluders. Small amount of residual shunt occurred in 2 patients after the operation and it disappeared 3 months after the operation. One patient with right bundle branch block, which disappeared after 1 week of observation. There were no complications such as occluder closure, pericardial effusion or valve regurgitation during the perioperative period. During the follow-up period [3-18(9.25±5.04) months], no serious complication occurred. Conclusion Transesophageal ultrasound-guided transfemoral artery occlusion for VSD is simple and safe, and it avoids the damage of radiation and contrast medium. It has advantages over traditional percutaneous interventional occlusion therapy.

关 键 词：室间隔缺损 经食管超声心动图 股动脉 介入治疗 

分 类 号：R654.2[医药卫生—外科学]