摘要
目的:分析经皮球囊肺动脉瓣成形术(PBPV)治疗单纯性肺动脉瓣狭窄(PS)的疗效,以提高治愈率,减少并发症。方法:回顾性分析2004年7月至2011年6月采用PBPV治疗的75例PS患儿的临床资料,比较扩张前后肺动脉和右心室压力变化以及球囊的选择情况、术后并发症。结果:75例PS患儿术前右心室收缩压为(70.24±23.54)mm Hg,术后即刻心导管检测降为(34.75±9.12)mm Hg(P<0.01);跨肺动脉瓣压力阶差(△P)术前为(49.41±22.57)mm Hg,术后即刻心导管检测降为(11.33±7.25)mm Hg(P<0.01),术后即刻心导管检测跨肺动脉瓣压力阶差<25 mm Hg达94.67%,术后24 h经超声测定△P为(23.04±9.80)mm Hg;术后1月、术后3月、术后6月及术后1年超声测定△P均较术后24 h明显下降;右心室造影肺动脉瓣环直径为(13.76±3.18)mm,所选球囊大小为(16.70±3.68)mm;无严重并发症和死亡病例发生。结论:PBPV治疗儿童PS安全有效。结合术前超声和右室造影判断肺动脉瓣环大小,选择合适大小球囊是介入成功的关键。
Objective： To analyze the effect of percutaneous balloon puhnonary valvuloplasty （PBPV） for children with pulmonary valve stenosis （PS） , in order to improve the cure rate and reduce complications. Methods： Seventy-five cases with PS treated by PBPV from July 2004 to June 2011 were analyzed retrospectively. The change of pressure of pulmonary and right ventricle before and after PBPV, and the size of pulmonary artery valve ring and balloon were compared. The complications after PBPV were observed. Results： The mean systolic pressure of right ventricle was （70.24±23.54） mm Hg before dilation, and it reduced to （34.75±9.12） mm Hg right after the procedure （ P〈0.01 ）. The systolic pressure gradient across the pulmonary valve （ △ P） was （49.41±22.57 ） mm Hg before dilation, and reduced to （11.33±7.25） mm Hg right after dilation （P〈0.01）. The gradient pressure after dilation was less than 25 mm Hg （ up to 94.67% ）. The systolic pressure gradient across the pulmonary valve （△p） measured by ultrasound after 24 hours was （23.04±9.80） mm Hg, and it further decreased after PBPV in one month, three months, six months and one year; the diameter of pulmonary valve ring tested by angiography was （13.76±3.18） mm, and the size of the selected balloon was （16.70±3.68） ram. No serious complications and deaths occurred in this group. Conclusions： PBPV is effective and safe in treatment for children with PS; with preoperative ultrasound and right ventricular angiography to determine the size of the pulmonary valve ring, the key to success is to select the appropriate size of balloons.
出处
《儿科药学杂志》
CAS
2013年第4期18-20,共3页
Journal of Pediatric Pharmacy
基金
国家"十一五"计划支撑项目资助课题
编号:2007BAI05B03
关键词
肺动脉瓣狭窄
经皮球囊肺动脉瓣成形术
儿童
Pulmonary valve stenosis
Percutaneous balloon pulmonary valvuloplasty
Children
