经食道超声引导下卵圆孔未闭封堵术的安全性和有效性  

Safety and Efficacy of Transesophageal Ultrasound-guided Patent Foramen Ovale Closure

作　　者：张薇 程帅 李琳 杨帆 朱占占 张申伟 ZHANG Weia;CHENG Shuaia;LI Lina;YANG Fanb;ZHU Zhanzhana;ZHANG Shenweia(Department of lnternal Medicine-Cardiovascular and Ultrasound,The Seventh People's Hospital of Zhengzhou City,Zhengzhou 450000 China)

机构地区：[1]郑州市第七人民医院心内科,郑州450000 [2]郑州市第七人民医院彩超室,郑州450000

出　　处：《内蒙古医学杂志》2024年第12期1434-1437,1441,共5页Inner Mongolia Medical Journal

基　　金：2021年河南省医学科技攻关计划项目(联合共建)(编号:LHGJ20220835)。

摘　　要：目的探讨经食道超声引导下卵圆孔未闭封堵术的安全性和有效性。方法选取2020年1月至2022年10月于郑州市第七人民医院心内科诊断为卵圆孔未闭(PFO)的患者148例,随机分为DSA组(n=88)和食道超声组(n=60),对比两组术中手术时间、射线时间、导丝跨间隔失败例数、封堵器回收调整例数以及术中封堵器脱落例数,随访半年后,比较两组手术并发症及残余分流情况。结果DSA组较食道超声组手术时间短,但两组差异无统计学意义(P>0.05);DSA组平均射线时间为(24.93±9.10)min,食道超声组射线时间为0 min,两组差异有统计学意义(P<0.05)。DSA组有5例因导丝跨间隔失败放弃手术,食道超声组1例导丝跨间隔失败放弃手术,两组差异无统计学意义(P>0.05)。DSA组术中调整封堵器位置12例,封堵器脱落1例;食道超声组术中调整封堵器位置2例,无封堵器脱落患者,两组差异无统计学意义(P>0.05)。两组术后半年随访:DSA组中存在右向左分流者3例,其中Ⅰ级1例、Ⅱ级2例;食道超声组中同样存在3例右向左分流,其中Ⅰ级2例、Ⅱ级1例,两组差异无统计学意义(P>0.05)。两组患者中均无右向左Ⅲ级分流。两组均未发现心内膜炎、原位血栓形成、封堵器脱落等并发症。结论食道超声可全程无射线下精确指导完成卵圆孔封堵,是一项安全、有效的技术,具有一定的临床应用价值。Objective To evaluate the safety and efficacy of transesophageal echocardiography-guided closure of patent foramen ovale(PFO).Methods A total of 148 patients diagnosed with PFO in the Department of Cardiology of the Seventh People's Hospital of Zhengzhou from January 2020 to October 2022 were selected.According to the randomization principle,they were divided into DSA closure group(n=88)and transesophageal echocardiography closure group(n=60).The operation time,radiation time,the number of guide wire interval failure cases,the number of occluder recovery adjustment cases,and the number of occluder falling off cases were compared between the two groups.After half a year of follow-up,the surgical complications and residual shunt were compared between the two groups.Results The operation time of DSA group was shorter than that of esophageal ultrasound group,but there was no significant difference between the two groups(P>0.05).The average irradiation time of DSA group was(24.93±9.10)min,and that of esophageal ultrasound group was 0min,the difference between the two groups was statistically significant(P<0.05).There were 5 cases in DSA group and 1 case in esophageal ultrasound group giving up surgery due to failure of guide wire crossing septum,and there was no significant difference between the two groups(P>0.05).There were 12 cases of occluder position adjustment and 1 case of occluder dislodgment in the DSA group,while there were 2 cases of occluder position adjustment and no occluder dislodgment in the esophageal ultrasound group.There was no significant difference between the two groups(P>0.05).There were 3 cases of right to left shunt in DSA group,including 1 case of gradeⅠand 2 cases of gradeⅡ.There were 3 cases of right to left shunt in esophageal ultrasound group,including 2 cases of gradeⅠand 1 case of gradeⅡ.There was no significant difference between the two groups(P>0.05).There were no right-to-left gradeⅢshunts in either group.No complications such as endocarditis,in situ thrombosis and occlu

关 键 词：经食道超声 卵圆孔未闭 介入封堵治疗 

分 类 号：R654.22[医药卫生—外科学]