摘要
目的观察经皮球囊肺动脉瓣成形术(PBPV)治疗肺动脉瓣狭窄(PS)患儿的术后疗效及安全性。方法对本院2005-2008年采用PBPV治疗的PS患儿54例进行分析。首选右心导管分别测量患儿右心房、右心室及肺动脉压力,然后单球囊法扩张其肺动脉瓣,术后采用超声心动图评价疗效。结果右室收缩压:PS患儿术前(65.30±25.40)mmHg(1 mmHg=0.133 kPa),术后(34.20±10.08)mmHg;跨肺动脉瓣压力阶差(PG):PS患儿术前(50.30±20.01)mmHg,术后1 d(19.96±6.95)mmHg,术后1个月(19.40±6.87)mmHg;术后1 d PG<20 mmHg达89.7%,术后1个月PG<20 mmHg达92.1%。PS患儿均未观察到并发症发生,术中失血量少,无输血,术后生命体征平稳。术后1个月经超声心动图随访无再狭窄发生。术后心脏杂音减轻,震颤全部消失,心电图大部分正常。结论PBPV治疗PS是安全有效。病例选择、精确测定肺动脉瓣直径和选择大小合适的球囊是手术成功的重要环节。
Objective To summarize the postoperative therapeutic effect and safety of pereutaneous balloon pulmonary valvuloplasty （PBPV） on pulmonary valve stenosis （PS） in children. Methods Fifty -four children with PS from 2005 to 2008 in Children＇s Hospital of Chongqing Medical University were treated by PBPV. The right cardiac catheterization was used to measure the right atrium and right ventricle pressure and the puhnonary cardiac pressure, then single balloon kyphoplasty was used to dilate pulmonary artery valve and the postoperative therapeutic effect was evaluated by echocardiography. Results Right ventricular pressure of these cases was （65.30 ± 25.40） mmHg （ 1 mmHg = 0.133 kPa） before PBPV, and decreased to （34.20 ± 10, 08 ） mmHg after PBPV. The pressure across the pulmonary valve was aboot （50.30±20.01 ） mmHg before PBPV and decreased to （ 19.96±6.95） mmHg after PBPV 1 day, （ 19.40±6.87） mmHg after PBPV 1month. The pressure gradient （PG） across the pulmonary valve in 89.7% children was less than 20 mmHg after PBPV 1 day and the PG across the pulmonary valve in 92.1% children was less than 20 mmHg after PBPV 1 month. Conclusions PBPV is safe and effective in children with PS. It is important that chosing suitable patient, accurate examing diameter of pulmonary valve and appropriate size of balloon be chosen in the treatment.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2010年第1期72-73,共2页
Journal of Applied Clinical Pediatrics
关键词
肺动脉瓣狭窄
经皮球囊肺动脉瓣成形术
儿童
puhnonary valve stenosis
pereutaneous balloon pulmonary valvuloplasty
child
