摘要
目的探讨经房间隔穿刺途径介入封堵术治疗卵圆孔未闭(PFO)的临床效果。方法选择2017年1月至2019年1月南阳市中心医院收治的77例PFO患者为研究对象,根据手术途径将患者分为观察组和对照组,观察组32例患者行经卵圆孔途径介入封堵术失败后转为经房间隔穿刺途径介入封堵术,对照组45例患者成功实施经卵圆孔途径介入封堵术。记录2组患者X线曝光时间、手术时间、苏醒时间及住院时间;分别于术前和术后1个月应用经食管超声心动图检查患者左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室搏出量(LVSV)及左心室射血分数(LVEF);所有患者术后随访12个月,观察Ⅲ度房室传导阻滞(AVB)、严重残余分流、新发心房颤动、心肌梗死、封堵术相关的再次住院、消化道出血、死亡等不良事件发生情况。结果2组患者均顺利完成手术,即刻手术成功率为100.00%。观察组患者X线曝光时间、手术时间显著长于对照组(P<0.05),2组患者苏醒时间、住院时间比较差异无统计学意义(P>0.05)。2组患者术前LVEDV、LVESV、LVSV、LVEF比较差异无统计学意义(P>0.05);观察组患者术后1个月LVEDV显著高于术前,对照组患者术后1个月LVEDV、LVSV显著高于术前(P<0.05);2组患者术后1个月LVEDV、LVESV、LVSV、LVEF水平比较差异无统计学意义(P>0.05)。术后12个月,观察组患者Ⅲ度AVB、严重残余分流、新发心房颤动、心肌梗死、封堵术相关的再次住院、消化道出血的发生率分别为9.38%(3/32)、6.25%(2/32)、15.63%(5/32)、6.25%(2/32)、6.25%(2/32)、9.38%(3/32),对照组患者Ⅲ度AVB、严重残余分流、新发心房颤动、心肌梗死、封堵术相关的再次住院、消化道出血的发生率分别为2.22%(1/45)、2.22%(1/45)、6.67%(3/45)、13.33%(6/45)、2.22%(1/45)、11.11%(5/45),2组患者Ⅲ度AVB、严重残余分流、新发心房颤动、心肌梗死、封堵术相关的再次住院、消
Objective To investigate the effect of transcatheter closure of transatrial septal puncture in the treatment of patent foramen ovale(PFO).Methods Seventy-seven patients with PFO admitted to Nanyang Central Hospital from January 2017 to January 2019 were selected as the research subjects,and they were divided into observation group and control group according to the surgical approach.The 32 patients who had failed transcatheter closure of via foramen ovale in the observation group were treated with transcatheter closure of transatrial septal puncture,while the 45 patients in the control group were successfully treated with transcatheter closure via foramen ovale.The X-ray exposure time,operation time,awakening time and hospitalization time of the patients in the two groups were recorded.The left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),left ventricular stroke volume(LVSV)and left ventricular ejection fraction(LVEF)were detected by transesophageal echocardiography before and one month after operation.All patients were followed up for 12 months to observe the occurrence of adverse events such as gradeⅢatrioventricular block(AVB),severe residual shunt,new onset atrial fibrillation,myocardial infarction,operation related rehospitalization,gastrointestinal bleeding and death.Results The operation of the patients in both groups was successfully completed,and the immediate success rate was 100.00%.The X-ray exposure time and operation time of the patients in the observation group were significantly longer than those in the control group(P<0.05),but there was no significant difference in the awakening time and hospitalization time between the two groups(P>0.05).There was no significant difference in the LVEDV,LVESV,LVSV and LVEF between the two groups before operation(P>0.05).The LVEDV of patients at one month after operation was significantly higher than that before operation in the observation group,while the LVEDV and LVSV of patients at one month after operation were signif
作者
王登峰
张超
韩冬
杨侃
WANG Dengfeng;ZHANG Chao;HAN Dong;YANG Kan(Department of Cardiovascular Surgery,Nanyang Central Hospital,Nanyang 473009,Henan Province,China)
出处
《新乡医学院学报》
CAS
2021年第2期169-172,共4页
Journal of Xinxiang Medical University
关键词
卵圆孔未闭
经房间隔穿刺
介入封堵术
左心房功能
patent foramen oval
transatrial septal puncture
interventional closure
left atrial function
