摘要
目的:总结经导管介入治疗一侧肺动脉缺如合并先天性心脏病的疗效。方法:我科自2005年1月至2009年4月诊断5例一侧肺动脉缺如合并先天性心脏畸形,其中合并动脉导管未闭4例,合并房间隔缺损1例;左肺动脉缺如1例,右肺动脉缺如4例;本组男性1例,女性4例,年龄1.5～11岁,3例肺部反复感染、1例咯血及1例发绀。均通过临床体检、X线胸片、心电图、经胸超声心动图检查及多排CT或造影确诊。结果:4例合并动脉导管通过介入治疗成功封堵。术后平均3d出院,未出现并发症,随诊3个月～4年心脏均恢复正常大小。1例肺动脉高压为极重度,合并房间隔缺损,出现发绀,不能除外原发肺动脉高压因素,放弃介入治疗,予口服扩血管药物治疗,出院随诊。结论:一侧肺动脉缺如合并先天性心脏病临床常表现为中、重度肺动脉高压多伴一侧肺发育不良,手术风险大。应用介入治疗显示出创伤小、并发症少,恢复快等优势,挽救了一些外科也难以处理的高风险重症患儿。
Objective：This study was to evaluate the safety and efficacy of transcatheter closure in the unilateral absence of a pulmonary artery（UAPA） combined congenital heart diseases.Methods：From January 2005 to April 2009,multi-slice spiral CT or angiogram confirmed the diagnosis of UAPA in 5 patients（1 boy and 4 girls）,including 4 patients with patent ductus arteriosus（PDA）,1 with atrial septal defect（ASD）;age（1.5-11） years old;1 cases of absence of the left and 4 cases of absence of the right,the main symptoms were repeated lung infections（3 /5）,hemoptysis（1 /5）,and cyanosis（1 /5）.The 5 patients were also assessed with electrocardiogram（ECG）,X ray check and transthoracic echocardiography（TTE） before the procedure.Re-sults：4 patients with PDA were treated successfully,there were no severe complications.Follow up ranges from 3months to 4 years,and it shows a good therapeutic efficacy.1 patient combined ASD with severe pulmonary hypertension and cyanosis were given up occlusion.Conclusion：Pulmonary hypertension was found in the UAPA combined congenital heart diseases,interventional treatment at one procedure is an effective and safe technique in selected patients.
出处
《心肺血管病杂志》
CAS
2011年第3期195-197,共3页
Journal of Cardiovascular and Pulmonary Diseases
关键词
肺动脉缺如
先天性心脏病
动脉导管未闭
房间隔缺损
介入治疗
Unilateral absence of a pulmonary artery
Congenital heart diseases
Patent ductus arteri-osus
Atrial septal defect
Interventional procedure
