Background： Percutaneous balloon pulmonary valvuloplasty （PBPV） is the preferred therapy for pulmonary valve stenosis （PVS）. This study retrospectively reviewed recent PBPV outcomes in infants with PVS. The aim o...Background： Percutaneous balloon pulmonary valvuloplasty （PBPV） is the preferred therapy for pulmonary valve stenosis （PVS）. This study retrospectively reviewed recent PBPV outcomes in infants with PVS. The aim of this study was to evaluate factors associated with immediate therapeutic outcomes and restenosis during medium-term follow-up. Methods： The study included 158 infants with PVS who underwent PBPV from January 2009 to July 2015. Demographic characteristics and patient records were reviewed, including detailed hospitalization parameters, hemodynamic data before and immediately after balloon dilation, cineangiograms,and echocardiograms before PBPV and at each follow-up.All procedures were performed by more than two experienced operators. Results： Immediately after balloon dilation, the pressure gradient across the pulmonary valve decreased from 73.09 ± 21.89 mmHg （range： 43-151 mmHg） to 24.49 ± 17.00 mmHg （range： 3-92 mmHg; P 〈 0.001） and the right ventricular systolic pressure decreased from 95.34 ± 23.44 mmHg （range： 60-174 mmHg） to 52.07 ± 18.89 mmHg （range： 22-134 mmHg; P 〈 0.001）. Residual transvalvular pressure gradientsof67.31±15.19mmHg（range：50-92mmHg）werefoundin8.2%ofpatients,indicatingpoortherapeuticeffects;6.4%ofpatientshad variable-staged restenosis at follow-up and 3.8% underwent reintervention by balloon dilation or surgical repairs. Further analysis demonstrated that the balloon/annulus ratio showed statistically significant differences（P 〈 0.05） among groups with different therapeutic effects and between the restenosis and no-stenosis groups. Binary logistic regression analysis further revealed that higher balloon/annulus ratio （odds ratio： 0.005, 95% confidence interval： 0-0.39） was an independent protective factor for restenosis. The rate of severe complications was 1.9%. Conclusions： PBPV is a definitive therapy for infants with PVS based on its effectiveness, feasibility, and safety. Restenosis upon medium-term follow-u展开更多
目的评价两种手术方式十二指肠乳头括约肌切开术(EST)和十二指肠乳头括约肌切开后球囊扩张术(ESBD)处理巨大胆总管结石的疗效差异。方法计算机检索至2019年7月8日的Pubmed、Cochrane Central、Embase等外文数据库及中国知网、万方等中...目的评价两种手术方式十二指肠乳头括约肌切开术(EST)和十二指肠乳头括约肌切开后球囊扩张术(ESBD)处理巨大胆总管结石的疗效差异。方法计算机检索至2019年7月8日的Pubmed、Cochrane Central、Embase等外文数据库及中国知网、万方等中文数据库中的文献,同时检索相关会议论文等,纳入ESBD vs EST治疗巨大胆总管结石的随机对照试验(RCT),提取相关数据,采用RevMan5.3软件进行分析。结果共纳入13项RCT,共计1926例患者,其中ESBD组973例,EST组953例。Meta分析结果显示:ESBD组和EST组结石清除率[比值比(OR)=1.53,95%可信区间(95%CI):1.03~2.29,P=0.04]、一次清除率(OR=1.77,95%CI:1.06~2.93,P=0.03)、机械碎石率(OR=0.40,95%CI:0.25~0.63,P<0.0001)、出血率(OR=0.23,95%CI:0.11~0.50,P<0.001)、胆管炎发生率(OR=0.31,95%CI:0.12~0.78,P=0.01)、早期并发症(OR=0.59,95%CI:0.42~0.84,P=0.003)、手术时间(MD=-8.89,95%CI:-17.56^-0.22,P=0.04)比较,差异均有统计学意义;但在穿孔(OR=0.27,95%CI:0.05~1.30,P=0.10)、内镜后胰腺炎(OR=1.03,95%CI:0.66~1.61,P=0.91)方面二者结果相似。结论在内镜下处理巨大胆总管结石中,ESBD在结石清除率、机械碎石率、出血率、胆管炎发生率、手术时间方面比EST更有优势。展开更多
Objectives: This study is to introduce of the clinical experience of percutaneous mitral balloon valvuloplasty 350 cases in Chinese and the long term follow up. Method: The modfied Inoue method was performed. Results:...Objectives: This study is to introduce of the clinical experience of percutaneous mitral balloon valvuloplasty 350 cases in Chinese and the long term follow up. Method: The modfied Inoue method was performed. Results: Effective PBMV was performed in 344 cases, the success rate was 98.3%:mitral area assessed by 2 dimenrional echocardiography (1.11±0.29 to 2.19 ±0.40cm 2, P <0.01 ). One hundrad and five patients were followed at a mean (46.7± 26.3 ) months (range 9 months to 8.5 years). after procedure restenosis was 11.4%(12/15), death 2.9 %(3/105, cerebral embolism in 2, congestive heart failure in 1; mitral valve replacement in 3.8%(4/105). Conclusions: percutaneous mitral commissurotomy provided excellent immediate and lale clinical results.展开更多
目的探讨经皮肺动脉瓣球囊成形术(PBPV)处理法乐四联症(TOF)根治术后残余右室流出梗阻(RVOTO)的可行性及临床价值。方法2006年3月～2008年3月,我院共有5例TOF术后残余RVOTO的患者接受了PBPV术,其中男2例,女3例,年龄5～24岁,3例为残余肺...目的探讨经皮肺动脉瓣球囊成形术(PBPV)处理法乐四联症(TOF)根治术后残余右室流出梗阻(RVOTO)的可行性及临床价值。方法2006年3月～2008年3月,我院共有5例TOF术后残余RVOTO的患者接受了PBPV术,其中男2例,女3例,年龄5～24岁,3例为残余肺动脉瓣狭窄,2例为残余肺动脉瓣下狭窄,所有患者均经股静脉途径采用聚乙烯单球囊法或Inoue球囊法进行PBPV术,介入治疗前后测量肺动脉-右室峰值压差。所有患者介入术后24 h、3个月、6个月复查超声心动图、心电图进行随访。结果5例患者PBPV术均获成功,右室-肺动脉峰值压差平均由术前的61 mm Hg下降至9.6 mm Hg,无严重并发症发生,平均随访7.2个月(平均3～12个月),无再狭窄发生。结论TOF外科根治术后残余RVOTO中的部分病例,可采用PBPV术有效解除梗阻,避免二次手术的风险。展开更多
文摘Background： Percutaneous balloon pulmonary valvuloplasty （PBPV） is the preferred therapy for pulmonary valve stenosis （PVS）. This study retrospectively reviewed recent PBPV outcomes in infants with PVS. The aim of this study was to evaluate factors associated with immediate therapeutic outcomes and restenosis during medium-term follow-up. Methods： The study included 158 infants with PVS who underwent PBPV from January 2009 to July 2015. Demographic characteristics and patient records were reviewed, including detailed hospitalization parameters, hemodynamic data before and immediately after balloon dilation, cineangiograms,and echocardiograms before PBPV and at each follow-up.All procedures were performed by more than two experienced operators. Results： Immediately after balloon dilation, the pressure gradient across the pulmonary valve decreased from 73.09 ± 21.89 mmHg （range： 43-151 mmHg） to 24.49 ± 17.00 mmHg （range： 3-92 mmHg; P 〈 0.001） and the right ventricular systolic pressure decreased from 95.34 ± 23.44 mmHg （range： 60-174 mmHg） to 52.07 ± 18.89 mmHg （range： 22-134 mmHg; P 〈 0.001）. Residual transvalvular pressure gradientsof67.31±15.19mmHg（range：50-92mmHg）werefoundin8.2%ofpatients,indicatingpoortherapeuticeffects;6.4%ofpatientshad variable-staged restenosis at follow-up and 3.8% underwent reintervention by balloon dilation or surgical repairs. Further analysis demonstrated that the balloon/annulus ratio showed statistically significant differences（P 〈 0.05） among groups with different therapeutic effects and between the restenosis and no-stenosis groups. Binary logistic regression analysis further revealed that higher balloon/annulus ratio （odds ratio： 0.005, 95% confidence interval： 0-0.39） was an independent protective factor for restenosis. The rate of severe complications was 1.9%. Conclusions： PBPV is a definitive therapy for infants with PVS based on its effectiveness, feasibility, and safety. Restenosis upon medium-term follow-u
文摘目的评价两种手术方式十二指肠乳头括约肌切开术(EST)和十二指肠乳头括约肌切开后球囊扩张术(ESBD)处理巨大胆总管结石的疗效差异。方法计算机检索至2019年7月8日的Pubmed、Cochrane Central、Embase等外文数据库及中国知网、万方等中文数据库中的文献,同时检索相关会议论文等,纳入ESBD vs EST治疗巨大胆总管结石的随机对照试验(RCT),提取相关数据,采用RevMan5.3软件进行分析。结果共纳入13项RCT,共计1926例患者,其中ESBD组973例,EST组953例。Meta分析结果显示:ESBD组和EST组结石清除率[比值比(OR)=1.53,95%可信区间(95%CI):1.03~2.29,P=0.04]、一次清除率(OR=1.77,95%CI:1.06~2.93,P=0.03)、机械碎石率(OR=0.40,95%CI:0.25~0.63,P<0.0001)、出血率(OR=0.23,95%CI:0.11~0.50,P<0.001)、胆管炎发生率(OR=0.31,95%CI:0.12~0.78,P=0.01)、早期并发症(OR=0.59,95%CI:0.42~0.84,P=0.003)、手术时间(MD=-8.89,95%CI:-17.56^-0.22,P=0.04)比较,差异均有统计学意义;但在穿孔(OR=0.27,95%CI:0.05~1.30,P=0.10)、内镜后胰腺炎(OR=1.03,95%CI:0.66~1.61,P=0.91)方面二者结果相似。结论在内镜下处理巨大胆总管结石中,ESBD在结石清除率、机械碎石率、出血率、胆管炎发生率、手术时间方面比EST更有优势。
文摘Objectives: This study is to introduce of the clinical experience of percutaneous mitral balloon valvuloplasty 350 cases in Chinese and the long term follow up. Method: The modfied Inoue method was performed. Results: Effective PBMV was performed in 344 cases, the success rate was 98.3%:mitral area assessed by 2 dimenrional echocardiography (1.11±0.29 to 2.19 ±0.40cm 2, P <0.01 ). One hundrad and five patients were followed at a mean (46.7± 26.3 ) months (range 9 months to 8.5 years). after procedure restenosis was 11.4%(12/15), death 2.9 %(3/105, cerebral embolism in 2, congestive heart failure in 1; mitral valve replacement in 3.8%(4/105). Conclusions: percutaneous mitral commissurotomy provided excellent immediate and lale clinical results.
文摘目的探讨经皮肺动脉瓣球囊成形术(PBPV)处理法乐四联症(TOF)根治术后残余右室流出梗阻(RVOTO)的可行性及临床价值。方法2006年3月～2008年3月,我院共有5例TOF术后残余RVOTO的患者接受了PBPV术,其中男2例,女3例,年龄5～24岁,3例为残余肺动脉瓣狭窄,2例为残余肺动脉瓣下狭窄,所有患者均经股静脉途径采用聚乙烯单球囊法或Inoue球囊法进行PBPV术,介入治疗前后测量肺动脉-右室峰值压差。所有患者介入术后24 h、3个月、6个月复查超声心动图、心电图进行随访。结果5例患者PBPV术均获成功,右室-肺动脉峰值压差平均由术前的61 mm Hg下降至9.6 mm Hg,无严重并发症发生,平均随访7.2个月(平均3～12个月),无再狭窄发生。结论TOF外科根治术后残余RVOTO中的部分病例,可采用PBPV术有效解除梗阻,避免二次手术的风险。
