食道超声引导下经皮封堵治疗卵圆孔未闭合并偏头痛儿童的临床分析  

Clinical Analysis of Esophageal Ultrasound-Guided Percutaneous Closure in the Treatment of Patent Foramen Ovale Children with Migraine

作　　者：郭海涛 蔺林 周晓明 杨玉齐[1] 范顺阳[1] GUO Haitao;LIN lin;ZHOU Xiaoming;YANG Yuqi;FAN Shunyang(Pediatric Cardiothoracic Surgery,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院小儿心胸外科,河南郑州450052

出　　处：《河南医学研究》2022年第23期4271-4274,共4页Henan Medical Research

摘　　要：目的探讨食道超声引导下经皮封堵技术在治疗卵圆孔未闭合并偏头痛儿童中的临床应用价值。方法2021年7月至2022年7月郑州大学第三附属医院收治的需要治疗的卵圆孔未闭患儿,7例适合微创封堵者接受食道超声引导下股静脉穿刺经导丝置入一体式封堵器关闭卵圆孔。观察7例患儿术前、术后二尖瓣反流程度,术前、术后三尖瓣反流程度,术后上腔静脉流速,术后下腔静脉流速,术后是否有残余分流,术前、术后偏头痛发作频率。结果7例患儿术后均未发生并发症,其中5例患儿二尖瓣及三尖瓣术后与术前反流程度相比无明显变化,1例患儿二尖瓣反流由术前的轻微变为术后的阴性,1例患儿三尖瓣反流由术前的轻微变为术后的轻度。7例患儿上腔静脉、下腔静脉及右上肺静脉血流速度均在正常范围。7例患儿均无术后残余分流。7例患儿术前均有不同频率偏头痛发作,在接受卵圆孔封堵术后1个月门诊复查时随访患儿偏头痛发作频率,5例患儿偏头痛未再发作,2例患儿偏头痛发作次数明显减少。结论本研究的初步结果表明食道超声引导下经皮封堵术在需要治疗的儿童卵圆孔未闭患者中是安全可行的,对于适合微创封堵者可以考虑使用该术式进行治疗。Objective To explore the clinical application value of esophageal ultrasound-guided percutaneous closure in patent foramen ovale children with migraine.Methods Between July 2021 to July 2022,seven consecutive patent foramen ovale children who needed treatment underwent esophageal ultrasound-guided percutaneous closure in the Third Affiliated Hospital of Zhengzhou University.Degree of mitral and tricuspid regurgitation before and after closure,postoperative velocity of superior and inferior vena cava,residual split-flow and frequency of migraine attack before and after surgery were recorded.Results No postoperative complications occurred in seven cases.Five cases had no significant change in mitral and tricuspid regurgitation before and after surgery,slight mitral regurgitation in one case was disappeared after surgery,and tricuspid regurgitation in one case changed from slight to mild after surgery.The blood flow velocity of superior vena cava,inferior vena cava and right superior pulmonary vein in 7 cases were within normal range,and no postoperative residual shunt was found in all of 7 cases.All the 7 children had frequency of migraine attack before surgery.The frequency of migraine attacks was followed up at outpatient review one month after foramen ovalue occlusion,migraine attack in 5 cases had disappeared after surgery,and the frequency of migraine attack was also significantly reduced in the other 2 cases.Conclusion These preliminary results suggest that esophageal ultrasound-guided percutaneous closure is safe and feasible in children with patent foramen ovale who need treatment,and this technique can be considered for the treatment of those who are suitable for minimally invasive closure.

关 键 词：卵圆孔未闭 食道超声心动图 经皮封堵 儿童 

分 类 号：R459.9[医药卫生—治疗学]