单纯经胸超声心动图引导经皮行卵圆孔未闭封堵术的安全性及临床价值分析  

Safety and Clinical Value of Percutaneous Closure of Patent Foramen Ovale Guided Solely by Transthoracic Echocardiography.

作　　者：唐仕海 周洋[1] 刘浪 赵飞[1] 何佳林 郑波 邵剑鹏 Tang Shihai;Zhou Yang;Liu Lang(Cardiovascular Department,The People′s Hospital of Leshan,Leshan,Sichuan 614000,China.)

机构地区：[1]乐山市人民医院心脏大血管外科,四川乐山614000

出　　处：《四川医学》2022年第9期853-857,共5页Sichuan Medical Journal

基　　金：四川省医学青年创新科研课题(编号:Q20065);乐山市重点研究课题(编号:20SZD036)。

摘　　要：目的探讨单纯经胸超声心动图(TTE)引导下,经皮行卵圆孔未闭(PFO)封堵术的安全性及临床价值。方法回顾性分析我科2021年4至12月收治的PFO封堵适应证患者,拟实施单纯经TTE引导下(TTE引导组)经皮PFO封堵的患者51例,其中男13例,女38例,平均年龄(46.76±9.62)岁。经X线透视下引导(X线引导组)封堵的患者61例,其中男14例,女47例,平均年龄(43.18±11.38)岁。比较两组患者手术成功率、手术时间、术中并发症、术后住院时间以及两组患者手术前后右心声学造影房水平右向左分流情况的变化。结果所有患者均成功经皮行PFO封堵术,TTE引导组有4例中转X线透视引导封堵。TTE引导组手术时间较X线引导组手术时间更长(P<0.05);TTE引导组手术成功率低于X线引导组(P<0.05);两组患者术中并发症无明显差异(P>0.05),术后住院时间无明显差异(P>0.05)。两组患者术后经胸右心声学造影结果较术前均有明显改善(P<0.05),两组间差异无统计学意义(P>0.05)。结论经胸超声心动图引导下经皮行卵圆孔未闭封堵术是安全、可行的,且具有局麻、无射线的双重优势,医患双方均受益,更微创,值得临床推广。Objective To investigate the safety and clinical value of percutaneous closure of patent foramen ovale(PFO)under the guidance of transthoracic echocardiography(TTE)alone.Methods From April to December 2021,patients who admitted and underwent percutaneous PFO occlusion in our hospital were retrospectively analyzed.All cases were divided into two groups.One group underwent by TTE guided(TTE guided group)and another group underwent by fluoroscopically guided(X-ray guided group).There were 51 cases in TTE guided group,including 13 males and 38 females,with a mean age of(46.76±9.62)years.61 cases were in X-ray group,including 14 males and 47 females,with a mean age of(43.18±11.38)years.The success rate of operation,operative time,intraoperative complications and length of postoperative hospital stay were compared.Preoperative and postoperative levels of contrast-Transthoracic Echocardiography were compared in each group and between two groups.Results All patients were successfully treated with percutaneous PFO occlusion,and X-ray fluoroscopy was required by four cases in TTE guided group.Operative time was longer in TTE guided group than in X-ray guided group(P<0.05).The operative success rate of TTE guided group was lower than in X-ray guided group(P<0.05).There was no significant difference in the intraoperative complications and length of postoperative hospital stay between two groups(P>0.05).Levels of contrast-Transthoracic Echocardiography were significantly improved in both groups(P<0.05),and barely noticeable difference between two groups(P>0.05).Conclusion Percutaneous closure of PFO guided by transthoracic echocardiography alone would be safe and feasible,and operation would have dual advantages of local anesthesia and no radiation.Both doctors and patients could benefit from this procedure.It would be more minimally invasive and worthy of clinical promotion.

关 键 词：经胸超声心动图 卵圆孔未闭 经皮介入治疗 

分 类 号：R654.2[医药卫生—外科学]