介入治疗动脉导管未闭和房间隔缺损及其疗效评价

中国临床药理学与治疗学 ›› 2002, Vol. 7 ›› Issue (5): 431-433.

介入治疗动脉导管未闭和房间隔缺损及其疗效评价

汤圣兴, 纪勤炯, 张平洋¹, 朱向明¹, 曹蘅, 钱广玲, 王安才

皖南医学院弋矶山医院心内科,¹超声科, 芜湖 241001

收稿日期:2002-07-01 修回日期:2002-07-30 发布日期:2020-11-26
通讯作者: 汤圣兴, 男, 副教授, 副主任医师, 博士生。研究方向:先天性心脏病的介入治疗。Tel:0553-5738856-2313 E-mai l:tsx2229 @163.com

Evaluation of the efficacy of transcatheter closure for patients with patent ductus arteriosus and secundum atrial septal defect

TANG Sheng-Xing, JI Qing-Jiong, ZHANG Ping-Yang¹, ZHU Xiang-Ming¹, CAO Heng, QIAN Guang-Ling, WANG An-Cai

Department of Cardiology, 1Department of Ultrasound, Yijishan Hospital, Wannan Medical College, Wuhu 241001

Received:2002-07-01 Revised:2002-07-30 Published:2020-11-26

摘要/Abstract

摘要： 目的评价介入治疗先天性心脏病动脉导管未闭和心房间隔缺损的初步疗效。方法 16 例病人,其中动脉导管未闭(PDA) 7 例, 房间隔缺损(ASD) 9例。所有病例均经食道超声(TEE) 证实为PDA 或ASD, 并在透视或(和) TEE 下置入Amplatzer 封堵器。术后24 h、1、3 mon 和1 年分别经胸超声、心电图(ECG) 和X 线胸片检查评价治疗效果。结果 7 例PDA 病人, 选择封堵器的直径为(9.71 ±2.93) mm(6 ~ 14 mm);9 例ASD 病人, 球囊测量值为(27.30 ±6.82) mm (16 ~ 36 mm) 选择的封堵器的直径为(29.33 ±8.12) mm (18 ~ 38 mm)。技术成功率为100 %;术中未发现任何并发症, 无急诊手术病例。术后即刻造影或TEE 显示4 例存在少量分流, 术后24 h、1、3 mon 和1 年TTE 检查所有病例无残余分流和再通, 右房室缩小, 肺动脉压下降。结论经导管置入封堵器治疗PDA 和ASD 是一种有效的微创方法, 具有操作简单、安全、技术成功率高及封堵效果好等优点, 适合于各年龄的继发孔型ASD 和各种类型PDA 的介入治疗。

关键词: 动脉导管未闭, 房间隔缺损, 介入治疗

Abstract: AIM: To evaluate the efficacy of transcatheter closure for patients with patent dectus arteriosus (PDA) and secundum atrial septal defects (ASD). METHODS: Sixteen patents with PDA (n =7) and ASD (n =9), diagnosed by transesophageal echocardiography (TEE), were treated by transcatheter closure.Amplatzer occluder device was used in the percutaneous procedure under fluoroscopy and TEE.After the procedure, TEE was used to find whether any residual shunt remained.Transthoracic echocardiography (TTE), ECG and X-ray examination were applied to evaluate efficacy 24 h, 1mon, 3 mon and 1 year after the procedure. RESULTS: The mean balloon stretched diameter of the ASD was 27.30 ±6.82 (16 -36) mm, and the mean diameter of the occluder selected respectively were (29.33 ±8.12) mm at ASD and (9.71 ±2.93) mm at PDA.The success rate of placement of the occluder was 100 %.No complications occurred during the procedure, and no one needed for emergency surgery.Four cases were found very small residual shunts immediately after the procedure and no residual shunt were found after 24 h.Both pulmonary artery pressure and heart size were improved in 1 mon, 3 mon and 1 year. CONCLUSION: Transcatheter closure of secundum ASD and PDA using the occluder is an efficient microinvasive method for patients in any age.The operation is simple and safe with a high success rate of placement and a good occlusion effect.

Key words: patent dectus arteriosus, atrial septal defects, transcatheter closure

中图分类号:

R543.5

汤圣兴, 纪勤炯, 张平洋, 朱向明, 曹蘅, 钱广玲, 王安才. 介入治疗动脉导管未闭和房间隔缺损及其疗效评价[J]. 中国临床药理学与治疗学, 2002, 7(5): 431-433.

TANG Sheng-Xing, JI Qing-Jiong, ZHANG Ping-Yang, ZHU Xiang-Ming, CAO Heng, QIAN Guang-Ling, WANG An-Cai. Evaluation of the efficacy of transcatheter closure for patients with patent ductus arteriosus and secundum atrial septal defect[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2002, 7(5): 431-433.

[1]	庞胜峰, 张晶, 吴宁宁, 李茹, 曹军, 何胜虎. 急性冠脉综合征患者PCI术后短程双联抗栓后单用替格瑞洛的疗效观察[J]. 中国临床药理学与治疗学, 2022, 27(9): 1004-1009.
[2]	何胜虎，周胜华，张晶,王雪飞,王大新. 急性ST段抬高型心肌梗死急诊PCI发生恶性心律失常临床特点及替罗非班的影响[J]. 中国临床药理学与治疗学, 2016, 21(4): 432-435.
[3]	章霞, 柯永胜. 新型P2Y12受体抑制剂替格瑞洛临床研究进展[J]. 中国临床药理学与治疗学, 2014, 19(4): 459-464.
[4]	李益民, 黄进, 陆治平, 李翔宇, 何胜虎. 替罗非班对ST段抬高型急性心肌梗死患者血小板微粒的影响[J]. 中国临床药理学与治疗学, 2014, 19(12): 1403-1406.
[5]	周勇, 黄松群, 徐飞. 术前与术中使用替罗非班对急性ST段抬高心肌梗死急诊介入治疗慢血流的比较及安全性[J]. 中国临床药理学与治疗学, 2014, 19(11): 1268-1271.
[6]	贾亮亮, 柯永胜. 急性冠脉综合征患者接受经皮冠状动脉介入治疗前后抗凝策略[J]. 中国临床药理学与治疗学, 2013, 18(4): 469-475.
[7]	高儒雅, 张亚同, 曹国颖. 北京医院经皮冠状动脉介入治疗前后用药情况和建议[J]. 中国临床药理学与治疗学, 2013, 18(10): 1110-1115.
[8]	贾亮亮, 柯永胜. 急性冠脉综合征患者接受经皮冠状动脉介入治疗前后抗血小板策略[J]. 中国临床药理学与治疗学, 2012, 17(9): 1074-1080.
[9]	邓少雄, 郭南鸥, 郑渊, 黄文森. 替罗非班对急性ST段抬高型心肌梗死并糖尿病患者急诊经皮冠状动脉介入治疗术后血清MMP-9水平的影响及临床意义[J]. 中国临床药理学与治疗学, 2011, 16(7): 807-811.
[10]	邓少雄, 郑渊, 郭南鸥. 阿托伐他汀对急性心肌梗死冠脉介入治疗术后的疗效及再狭窄的影响[J]. 中国临床药理学与治疗学, 2010, 15(2): 199-203.
[11]	汤圣兴, 纪勤炯1, 朱向明, 张平洋, 曹蘅, 祈述善, 王安才. 介入治疗膜部室间隔缺损的疗效初评[J]. 中国临床药理学与治疗学, 2003, 8(1): 78-80.
[12]	陈绍良, 段宝祥, 叶飞, 方五旺, 胡作英, 黄进, 戴震林, 周陵, 罗俊, 林松, 查铭凡, 耿其吉. 冠状动脉介入治疗促进血管内皮素Ⅰ和血管紧张素Ⅱ的释放[J]. 中国临床药理学与治疗学, 2001, 6(4): 301-306.