极简式经导管卵圆孔未闭封堵术的临床应用及短期随访研究  

Clinical application and short-term follow-up study of minimally invasive transcatheter patent foramen ovale occlusion

作　　者：胡秋明[1] 吴凯胜 张文博 陈宗皓 韩杰[1] 贡鸣[1] Hu Qiuming;Wu Kaisheng;Zhang Wenbo;Chen Zonghao;Han Jie;Gong Ming(Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心脏外科,北京100029

出　　处：《中华胸心血管外科杂志》2025年第2期65-71,共7页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的:探究极简式经导管卵圆孔未闭封堵术临床应用的安全性及有效性。方法:回顾性分析2023年1月1日至2023年12月31日在北京安贞医院心脏外科进行经导管卵圆孔未闭封堵的部分患者123例。研究按照手术方案将患者分为常规封堵组(A组:53例)及极简式封堵组(B组:70例)。术后至少随访6个月以评估新方法的安全性及有效性。结果:两组的手术成功率均为100%。B组的术中透视时间下降50%以上(A组7 min,B组3 min,P<0.001)。术后半年随访对比增强经颅多普勒超声声学造影,7例阳性,其中2例大量分流,复查合并肺动静脉瘘。术后1例再次发生卒中,患者总体偏头痛、短暂性脑缺血等症状明显缓解,总体VAS评分较前明显下降。结论:极简式经导管卵圆孔未闭封堵术是一种安全、可靠、性价比高的手术方式,值得进一步随访及推广。同时,经皮卵圆孔未闭封堵术是预防患者再次卒中,缓解偏头疼、短暂性脑缺血等症状的有效治疗方式。Objective To investigate the safety and effectiveness of the clinical application of minimally invasive tran-scatheter patent foramen ovale occlusion.Methods A total of 123 patients who underwent transcatheter patent foramen ovale(PFO)occlusion at the Department of Cardiac Surgery of Beijing Anzhen Hospital from January 1,2023,to December 31,2023,were retrospectively analyzed.According to the surgical protocol,this study divided the patients into the conventional oc-clusion group(Group A,53 cases)and the minimal invasive occlusion group(Group B,70 cases).The patients were fol-lowed up for at least six months after surgery to evaluate the safety and effectiveness of the new method.Results The surgical success rate was 100%in both groups.Intraoperative fluoroscopy time decreased by over 50%(7 min in group A and 3 min in group B,P<0.001).At the six-month postoperative fllow-up,contrast-enhanced transcranial Doppler ultrasound sonography revealed seven positive results,two of which indicated large shunts.It was further reviewed for combined pulmonary arteriove-nous fistula.One patient experienced a recurrence of stroke after the surgery.The patients'overall migraine and transient ische-mia attack(TIA)were significantly relieved,and their overall VAS scores decreased significantly compared to the previous ones.Conclusion The minimally invasive transcatheter PFO occlusion procedure is safe,reliable,and cost-effective.It war-rants further follow-up and promotion.Meanwhile,transcatheter PFO occlusion is an effective treatment for preventing recurrent stroke and relieving symptoms like migraine and TIA in patients.

关 键 词：卵圆孔未闭 经导管卵圆孔未闭封堵术 微创 卒中 偏头痛 

分 类 号：R47[医药卫生—护理学]