成人房间隔缺损术后再住院超声心动图及临床病因的初步分析  

Preliminary analysis of echocardiography and clinical etiology of re-hospitalization after atrial septal defect in Adults

作　　者：许新新 王欣 郭勇[1] 刘文旭[1] 孙琳[1] 何怡华[1] XU Xinxin;WANG Xin;GUO Yong;LIU Wenxu;SUN Ling;HE Yihua(Department of Echocardiography Medical Center,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所、心脏超声医学中心,100029 [2]河北中石油中心医院超声科

出　　处：《心肺血管病杂志》2023年第9期946-951,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：胎儿心脏病母胎医学研究北京市重点实验室(BZ0308);心血管疾病精准医学北京实验室(PXM2018_014226_000013)。

摘　　要：目的:分析成人孤立型房间隔缺损(atrial septal defect,ASD)外科修补术或介入封堵术后患者再次住院治疗的病因。方法:收集2016年1月至2021年12月,于北京安贞医院进行孤立型ASD术后再次入院治疗的成人患者112例的临床及心脏超声资料,分析其再次入院治疗的病因。结果:本中心因孤立型ASD术后再次住院治疗患者112例,其中68例行外科修补术,44例行介入封堵术。术后1年以内于我院治疗的患者共16例,其中外科修补术后10例,介入封堵术后6例;心脏超声主要包括:心律失常11例、肺动脉高压(pulmonary hypertension,PH)2例、气胸1例、出血1例,肺动脉栓塞1例。因术后1年以上出现于我院就诊的患者共96例,其中外科修补术后58例,介入封堵术后38例;心脏超声主要包括:心律失常25例、中-重度PH 16例、心力衰竭6例、残余分流5例、PH合并心力衰竭2例、感染性心内膜炎1例、心房血栓1例,心力衰竭合并感染性心内膜炎及感染性休克1例。结论:成人孤立型ASD治疗后患者再次入院原因多样,在出现明显的症状之前,积极主动的行ASD关闭手术,能改善年轻人的预后,改善患者的生活质量,减少心血管疾病发生的风险。Objective:To summarize and analyze the causes of re-hospitalization in adult patients with isolated atrial septal defect(ASD)after surgical repair or interventional closure.Methods:The clinical and ultrasound data of adult patients with isolated atrial septal defect who underwent readmission in Beijing Anzhen Hospital from January 2016 to December 2021 were retrospectively collected,and the causes of readmission were analyzed.Results:A total of 112 patients were re-hospitalized after surgery for isolated ASD,of whom 68 underwent surgical repair and 44 underwent interventional occlusion.A total of 16 patients were treated in our hospital within 1 year after surgery,including 10 patients after surgical repair and 6 patients after interventional occlusion.Cardiac ultrasound mainly included:11 cases of arrhythmia,2 cases of pulmonary hypertension(PH),1 case of pneumothorax,1 case of hemorrhage,1 case of pulmonary embolism.A total of 96 patients were admitted to our hospital for more than 1 year after surgery,including 58 patients after surgical repair and 38 patients after interventional occlusion.Long-term echocardiography mainly included:25 cases of arrhythmia,16 cases of moderate to severe PH,6 cases of heart failure,5 cases of residual shunt,2 cases of PH combined with heart failure,1 case of infectious endocarditis,1 case of atrial thrombosis,and 1 case of heart failure combined with infectious endocarditis and septic shock.Conclusions:There are multiple reasons for readmission in adults with isolated ASD.Proactive ASD closure surgery prior to the onset of obvious symptoms can improve outcomes in young adults,improve patients'quality of life,and reduce the risk of cardiovascular disease.

关 键 词：房间隔缺损 外科修补术 超声心动图 介入封堵术 病因 

分 类 号：R54[医药卫生—心血管疾病]