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医学免费论文:国产封堵器治疗先天性心脏病疗效评价
【摘要】 目的：探讨国产封堵器在先天性心脏病介入治疗的临床疗效。方法：回顾分析2005年7月～2008年5月连续施行的先天性心脏病介入治疗51例，其中动脉导管未闭(PDA)14例，房间隔缺损(ASD)27例 ，室间隔缺损10例 ，术中行即刻造影和或经胸超声心动图(TTE)，术后5～7 d和半年复查经胸超声心动图，观察其手术安全性、术中和术后疗效。结果：其中50例即刻获得成功，成功率98%(50/51)。残余分流1例，即刻完全封堵率98%(49/50)，无一例急症手术或死亡。空气栓塞0.6%(3/51)，一过性Ⅱ°房室传导阻滞0.4%(2/51)。术后5～7 d和半年复查1例残余分流。结论：应用国产封堵器治疗先天性心脏病成功率高，创伤小，死亡率低，安全有效。
【关键词】 先天性心脏病 封堵术 经胸超声心动图医.学.全.在.线www.lindalemus.com
Therapeutic evaluation of Chinesemade amplatzer occluder device to treat congenital heart diseases
WU Zhongdong, JIANG Shubing, XU Lishu
(Department of Cardiology, Affiliated Traditional Chinese Medical Hospital,Xinjiang Medical University, Urumqi 830000, China)
Abstract: Objective: To evaluate the results of interventions in patients with congenital heart disease (CHD). Methods: The clinical effects of interventional therapy in consecutive patients with CHD at our hospital from July 2005 to May 2008 were retrospectively analyzed, and the patient distribution included patent ductus arteriosus (PDA)14 cases, atrial septal defect (ASD) 27 cases, ventricular septal defect (VSD)10 cases. An immediate angiography and transthoracic echocardiography (TTE) were used to observe the clinical effects. Results: Fifty cases were closed successfully, successful rate was 98%(50/51). Residual shunt was found in 1 case immediately and half a year. No mortality was observed. No surgical operation. Ⅱ°AVB in 2 cases(0.4%). Conclusion: Chinesemade Amplatzer occluder device to treat congenital heart diseases is effective and safe, there are no late complications, no mortality.
Key words: congenital heart disease; interventional therapy; transthoracic echocardiography
1997年Amplatz开发了新一代封堵器，因其具有不需开胸及体外循环、无手术疤痕、恢复快等优点，使常见先天性心脏病介入治疗进入成熟阶段[1]。而2000年国产器械的研制成功，进一步促进了介入治疗的发展[2]。我院于2005年7月～2008年5月应用国产先健TM封堵器治疗先天性心脏病房间隔缺损(ASD)、动脉导管未闭(PDA)、室间隔缺损(VSD)共51例，并对其疗效进行观察，现报告如下。
1资料与方法
1.1临床资料封堵介入治疗51例，男性20例，女性31例，年龄3～57岁，体重16～69 kg。PDA14例，ASD27例，VSD10例。超声心动图PDA管型5例，漏斗型9例，最狭窄处3～12 mm;ASD均为继发孔中央型直径4～32 mm;VSD膜部8例，直径4～10 mm，并膜部瘤形成1例，嵴内型1例。
1.2治疗方法应用国产先健TM封堵器及输送系统进行介入封堵治疗。在X线透视、造影及经胸超声心动图监视下，按照常规方法行介入封堵术，术后常规抗炎、抗凝治疗3 d，抗血小板治疗3～6个月。选择的封堵器直径PDA为6～14 mm，ASD为8～42 mm，VSD为6～14 mm。患者均于术后5～7 d、术后半年查心电图、胸透、经胸超声心动图。
2结果
