摘要
目的比较漂导丝法和去头猪尾管过室间隔法在室间隔膜部缺损介入封堵治疗中的优缺点。方法回顾分析2014年2月至2015年4月在四川大学华西第二医院行膜周部室间隔缺损介入封堵治疗的患者,以术中去头猪尾管过室间隔法建立轨道者为A组,术中使用漂导丝法建立轨道者为B组。比较两种方式的放射曝光时间,术中严重心律失常发生率,一次性建立动-静脉轨道成功率。结果研究共纳入患者312例,两组患者年龄、体重、性别等临床资料差异无统计学意义(P>0.05)。两组患者放射曝光时间比较差异无统计学意义(P>0.05)。术中A组心律失常发生率(53.6%)比B组(10.2%)明显增加,差异具有统计学意义(P<0.01);A组一次性建立轨道成功率(99.4%)比B组(95.8%)高,差异具有统计学意义(P<0.01)。结论去头猪尾管过室间隔法一次性建立轨道成功率高,但术中心律失常发生率增加,因此,对手术患者应权衡利弊。对于膜部室间隔缺损伴假性纤维瘤形成,且瘤体右心室面有多个破口,选择去头猪尾管过室间隔法成功率高;如果室间隔分流速度大,且室间隔左心室面缺损小,建议优先使用漂导丝法。
Objective To compare the efficiency and safety of transcatheter interventional occlusion of peri-membranous ventricular septal defect by floating guidewire skill or none head pigtail skill. Methods 312 patients who had accepted ventricular septal defect occluder in West China Second University Hospital from February 2014 to April 2015 were analyzed retrospectively. All the patients were divided into two groups according to whether throughing a ventricular septal defect with go head pigtail（ Group A） or using floating guide wire skills（ Group B）. Exposure time,the incidence of arrhythmia,one-time success rate on establishing the track were compared between the two groups. Results There were no statistical differences on the age,weight,gender and clinical date,etc（ P〉0. 05）. Radiation exposure time had no statistical significance between the two groups（ P〉0. 05）. Compared with group B,patients in group A showed higher one-time success rate in track establishment（ 99. 4% vs. 95. 8%） and higher incidences of arrhythmias（ 53. 6% vs. 10. 2%）,there were statistical differences（ all P〈0. 01）. Conclusions None head pigtail skill has high one-time success rate on establishing track,but increases the incidence of intraoperative arrhythmias,therefore,surgery should be weighed. None head pigtail skill is better option when ventricular septal defects with pseudo fibroma has more than one breach. Floating guidewire skill is a better choice if ventricular septal shunt Vmax value is bigger,or crevasse is small.
出处
《心血管外科杂志（电子版）》
2015年第4期12-15,共4页
Journal of Cardiovascular Surgery(Electronic Edition)
关键词
室间隔缺损
经导管介入封堵术
漂导丝法
去头猪尾管法
Heart septal defects
ventricular
Transcatheter closure
Floating guidewire skills
None head pigtail skills
