摘要
目的 通过与传统放射线引导方法相比较,评价单纯经食道超声（TEE）引导在经皮介入封堵儿童房间隔缺损中的早期临床应用效果.方法 收集2012年10月至2014年1月单纯TEE引导下经皮房间隔缺损封堵患儿50例（TEE组）,均采用TEE引导并监测封堵全过程.选取同期传统放射线引导下经皮房间隔缺损封堵患儿162例为对照组.2组患者均于术后1个月在门诊随访,并行经胸超声心动图检查.结果 2组患儿年龄、体质量、房间隔缺损直径、封堵器直径、手术时间及住院时间无明显差异.TEE组和对照组封堵器置入成功率分别为100.0％和97.5％,2组比较差异无统计学意义（P=0.58）;术后即刻残余分流发生率分别为0和4.4％,2组比较差异无统计学意义（P=0.20）;气管插管时间分别为（2.9±0.5）h和0.术后随访1个月,2组患者均无残余分流,未发生外周血管损伤、心脏穿孔、封堵器脱落等严重并发症.结论 单纯TEE引导下经皮介入封堵儿童房间隔缺损不仅能够完全避免放射线及对比剂,而且保持了传统经皮介入治疗安全、微创的优点.
Objective To investigate the early clinical effects of using transesophageal echocardiography （TEE） in order to guide percutaneous transcatheter closure of atrial septal defect in children in comparison to fluoroscopy.Methods From Oct.2012 to Jan.2014,50 cases of consecutive children （TEE group） undergoing percutaneous transcatheter closure of atrial septal defect received the procedure completely guided and monitored by TEE.One hundred and sixty-two children who guided by conventional fluoroscopy during the same period served as controls.After 1 month of the operation,patients of 2 groups were followed up by conducting transthoracic echocardiography.Results The mean age,mean body weight,the mean size of atrial septal defect and occlusion,procedure time,and hospital stay time had no statistical differences between 2 groups.In comparison with the TEE group and control group,there were no differences in the rate of successful occlusion （100.0% vs 97.5%,P =0.58） and immediate postoperative residual shunt （0 vs 4.4%,P =0.20）.The TEE group required general anesthesia intubation time lasted （2.9 ± 0.5） h and the control group was spontaneously breathing under sedation.During 1 month follow-up,there were no complications such as residual shunt,peripheral vascular injury,cardiac perforation or occluder abscission in all patients.Conclusions Percutaneous transcatheter closure of atrial septal defect completely guided by TEE is safe and minimally invasive in children.The procedure can avoid the injuries of radiation and contrast agent.Its effect can compete with that by using traditional fluoroscopy.
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2014年第18期1425-1427,共3页
Chinese Journal of Applied Clinical Pediatrics
基金
北京高等学校“青年英才计划”（YETP-1237）
