单纯经胸超声心动图引导下经皮行卵圆孔未闭封堵术的学习曲线及可行性研究  

Learning curve and feasibility study 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] 郑波 何佳林 邵剑鹏 Tang Shihai;Zhou Yang;Liu Lang;Zhao Fei;Zheng Bo;He Jialin;Shao Jianpeng(Cardiovascular Department of The People’s Hospital of Leshan,Leshan 614000,China)

机构地区：[1]乐山市人民医院心脏大血管外科,乐山614000

出　　处：《中华胸心血管外科杂志》2023年第6期321-325,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的:研究单纯经胸超声心动图(TTE)引导下,经皮行卵圆孔未闭(PFO)封堵术的学习曲线及成功率、安全性。方法:回顾性研究乐山市人民医院心脏大血管外科2021年4月至2022年4月收治的具有PFO封堵适应证的患者,单纯经TTE引导封堵前100例,其中男25例,女75例,年龄(48.22±10.44)岁。统计患者术前基线资料:性别、年龄、身高、体质量、体质量指数、经食管超声心动图卵圆孔未闭的隧道长度及孔径大小、经颅多普勒增强试验右向左分流大小、合并房间隔膨胀瘤等。分析所有患者手术时间、成功率、并发症等情况。结果:随着病例积累,手术时间逐渐缩短,积累到50例左右,手术时间有明显的缩短,学习曲线在50例以后趋于平稳,差异有统计学意义( P<0.05)。在学习曲线内的手术病例的成功率、并发症与完成学习曲线后的手术病例比较,差异无统计学意义( P>0.05)。 结论:经TTE引导下经皮行PFO封堵术学习曲线较长,约需50例,学习曲线过程中的成功率、安全性高,此术式值得推广。ObjectiveTo study the learning curve of percutaneous patent foramen ovale(PFO)occlusion guided solely by transthoracic echocardiography(TTE),as well as the success rate and safety of the learning curve.MethodsTo retrospectively analyze these patients with indications for PFO occlusion admitted in our department from April 2021 to April 2022,and obtained 100 samples the author's initial cases guided solely by TTE,including 25 men and 75 women,with a mean age of(48.22±10.44)years old.Analyze preoperative baseline data:gender,age,height,weight,body mass index,the tunnel length and size of the PFO measured by transesophageal echocardiography,the grade of contrast-transcranial doppler test,combined atrial septal aneurysm,etc.Operation time,success rate,and complications were analyzed in all patients.ResultsWith the accumulation of cases,the operation time gradually shortened,accumulated to about 50 cases,the operation time has significantly shortened(P<0.05),and the learning curve was leveled off after 50 cases(P<0.05),there was statistical difference.The comparison of the success rate and complication of cases within the learning curve and those after completing the learning curve was no statistical significance(P>0.05).ConclusionThe learning curve of percutaneousc closure of patent foramen ovale guided solely by TTE is long,requiring about 50 cases to complete the learning curve.The success rate and safety of the learning curve are high.This procedure is worth popularizing.

关 键 词：经胸超声心动图 卵圆孔未闭 经皮介入治疗 学习曲线 

分 类 号：R654.2[医药卫生—外科学] R540.45[医药卫生—临床医学]