经皮室间隔心肌化学消融术治疗肥厚型梗阻性心肌病疗效评价  

The efficacy of percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy

作　　者：傅国胜[1] 徐耕[1] 游向东[1] 马骥[1] 鲍晓峰[1] 童国新[1] 翁少翔[1] 程刚[1] 潘晓宏[1] 单江[1] 

机构地区：[1]浙江大学医学院附属第二医院,杭州310009

出　　处：《浙江医学》2003年第11期646-648,678,共4页Zhejiang Medical Journal

基　　金：浙江大学医学院附属第二医院科研发展基金 ;国家教育部留学回国人员科研基金

摘　　要：目的 评价经皮室间隔心肌化学消融术 (PTSMA)治疗肥厚型梗阻性心肌病 (HOCM)近期疗效 ,并探讨其方法学。方法 31名HOCM患者接受PTSMA治疗 ,6例采用心肌声学造影监测判断消融靶血管。结果 31例患者均成功实施PTSMA治疗 ,患者术前平均跨左心室流出道压力阶差 (71.6±25.7)mmHg,术中球囊充盈15min后为 (29.1±15.6)mmHg,消融术毕为 (21.6±7.7)mmHg,与术前比较均有显著下降 (均P<0.05) ;临床状况显著改善18例 ,明显改善9例 ,改善不显著4例 ;1例患者发生迟发性高度房室传导阻滞 ,经积极药物处理后传导阻滞消失 ,无死亡和需行永久性起搏治疗者。 结论 PTSMA手术是HOCM患者一项有效、相对安全的治疗方法。Objective To evaluate the efficacy of percutaneous transluminal septal myocardial ablation (PTSMA) for hypertrophic obstructive cardiomyopathy (HOCM).Methods Thirty one HOCM patients with resistant medical therapy underwent PTSMA by Sigward method. The intracoronary myocardial contrast echocardiography monitor was also used for identifying target ablation vessel in 6 of our patients.Results All patients were successfully treated by PTSMA with significant left ventricular outflow tract pressure gradient (LVOTPG) reduction (from 71.6±25.7mmHg to 21.6±7.7mmHg,P<0.05).This was associated with a significant improvement of symptoms.There were no permanent high-degree AV block or death in this group of patients.Conclusion PTSMA significantly reduces left ventricular outflow tract obstruction and improves symptoms.

关 键 词：经皮室间隔心肌化学消融术 治疗 肥厚型梗阻性心肌病 疗效评价 

分 类 号：R542.2[医药卫生—心血管疾病]