摘要
目的评价国产封堵器经导管介入封堵治疗儿童先天性心脏病的临床经验。方法选取2014年1月—2016年7月104例无锡儿童医院住院适合用介入方法封堵治疗的儿童先天性心脏病患者,男49例,女55例,年龄10个月5天~15岁,平均年龄(3.8±2.9)岁;体重8.5~68.0 kg,平均(16.25±9.3)kg。其中继发孔型房间隔缺损(ASD)54例,动脉导管未闭(PDA)21例,膜周部室间隔缺损(PVSD)26例,肌部室间隔缺损(MVSD)1例,膜周部室间隔缺损合并房间隔缺损1例,房间隔缺损合并动脉导管1例,均行国产封堵器介入治疗。房间隔缺损及室间隔缺损患儿术后口服阿司匹林3~5 mg/(kg·d)(最大量100 mg/d),疗程6个月。同时术后24 h复查胸片、心电图、心脏彩超,室间隔缺损封堵术后行24 h动态心电图检查。术后第1、3、6、12个月予心脏超声、心电图追踪及随访,以后每年常规复查心电图、心脏彩超。结果共植入国产封堵器106个,同时植入2个封堵器患儿4例。介入封堵成功102例,2例封堵失败,封堵成功率为98.08%。严重并发症发生率为0.96%,其他并发症17例。所有患者均无心包填塞,无封堵器移位,无溶血,无血栓或气栓形成。结论国产封堵器经导管介入封堵治疗儿童先天性心脏病临床疗效肯定,严重并发症发生率低,是一种安全、有效的治疗方法。但在治疗过程中应严格把握介入治疗的适应证及禁忌证,术后坚持长期随访心电图及心脏超声。
Objective To evaluate the clinical efficacy of China-made septal occluder in the transeatheter closure of congenital heart disease（CHD） in children. Methods A total of 104 children with congenital heart disease in our hospital from January, 2014 to July,2016 were selected for transcatheter closure, including 49 cases of male, 55 female, aged from 10 month 5 days to 15 years,mean （3.8 ＋ 2.9） years,weight from 8.5 to 68 mean （ 16.25 -＋ 9.3 ） kg. All patients were occluded with the China-made septal occluder including 54 patients with ostium secundum atrial septal defect（ASD） ,21 patents with patent ductus arteriosus（PDA）,26 with perimembranous ventricular septal defects（PVSD）,1 with muscular ventricular septal defect（ MVSD）, 1 with PVSD combined ASD and 1 ASD combined with PDA. The patients with ASD and VSD were treated with oral aspirin 3 -5 mg/（kg ·d） for a period of 6 months after the operation（most 100 mg/d）. Transthoracic echocardiography（TTE）, Chest radiograph and electrocardiograph （ECG） were performed immediately and after the procedure to evaluate the efficiency. Twenty-four hour dynamic ECG was performed after transcatheter closure of VSD. First month, third months, sixth months, and twelfth months and per annum after the operation, the patients were followed up by TTE and ECG. Results The total of 106 septal occluders had been implanted,while 4 patients implanted with 2 occluders. The incidence of serious complication was 1%, and the other complications were 17 cases. All the patients had no pericardial tamponade, no occluder shift, no hemolysis, no thrombosis or embolism formation. Conclusion The method to transcatheter closure with China-made septal occluder is safe and effective. The incidence of serious complication is very low. But in the course of treatment should be strictly grasp the indications and contraindications of inter- ventional treatment, postoperative long-term follow-up TTE and ECG.
作者
鞠樑
钱炜
李红
李琪
沙红
华琦
胡静
胥玲
JU Liang QIAN Wei LI Hong et al(Department of Cardiology, Wuxi Children＇ s Hospital, Wuxi ,Jiangsu 214023, China)
出处
《中华全科医学》
2017年第10期1735-1737,1801,共4页
Chinese Journal of General Practice
关键词
先天性心脏病
国产封堵器
介入治疗
儿童
Congenital heart disease
China-made septal occluder
Interventional therapy
Children
