中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2011年
8期
53-55
,共3页
袁义强%于力%黄琼%王瑞敏%赵育洁%郭应先%孙俊华%牛思泉%孙运%杨兴明
袁義彊%于力%黃瓊%王瑞敏%趙育潔%郭應先%孫俊華%牛思泉%孫運%楊興明
원의강%우력%황경%왕서민%조육길%곽응선%손준화%우사천%손운%양흥명
房间隔缺损%介入治疗
房間隔缺損%介入治療
방간격결손%개입치료
Atrial septal defect%Interventional therapy
目的 通过对继发孔型房间隔缺损(ASD)介入治疗的远期随访研究,评价其有效性和安全性.方法 选择ASD介入治疗的患者61例(男25例,女36例),于手术前、手术后3 d、3个月、6个月、1、2、5年分别进行随访,包括询问症状、检查心电图了解有无心律失常;并行超声心动图检查,观察封堵器状态、残余分流情况、心脏结构、心功能、有无封堵伞移位等.结果 术后随访,右心房上下径、左右径,右心室舒张末期左右径、右心室舒张末期容积在术后3 d就明显缩小,术后3个月进一步缩小(P＜0.05).右心室舒张末期长径在术后3个月才明显缩小(P＜0.05).术后3个月,右心室舒张末期容积、右心室收缩末期容积、右心室射血分数较术前进一步改善,差异具有统计学意义(P＜0.01).术后6个月右心房、右心室大小基本恢复正常.术后3 d,左室舒张末前后径、左室舒张末期容积均逐渐增大(与术前比较,P<0.05);左室收缩末期容积、左室每搏量及左室射血分数均逐渐增大(P＜0.05).3个月后左心功能进一步改善,至12个月时,左心房、左心室大小及左心室功能恢复正常(P＜0.01).随访期间,15例出现心悸症状,半年内自愈,无其他并发症.结论 ASD介入治疗在消除异常分流的同时,有效改善心脏结构和功能,长期疗效安全有效.
目的 通過對繼髮孔型房間隔缺損(ASD)介入治療的遠期隨訪研究,評價其有效性和安全性.方法 選擇ASD介入治療的患者61例(男25例,女36例),于手術前、手術後3 d、3箇月、6箇月、1、2、5年分彆進行隨訪,包括詢問癥狀、檢查心電圖瞭解有無心律失常;併行超聲心動圖檢查,觀察封堵器狀態、殘餘分流情況、心髒結構、心功能、有無封堵傘移位等.結果 術後隨訪,右心房上下徑、左右徑,右心室舒張末期左右徑、右心室舒張末期容積在術後3 d就明顯縮小,術後3箇月進一步縮小(P＜0.05).右心室舒張末期長徑在術後3箇月纔明顯縮小(P＜0.05).術後3箇月,右心室舒張末期容積、右心室收縮末期容積、右心室射血分數較術前進一步改善,差異具有統計學意義(P＜0.01).術後6箇月右心房、右心室大小基本恢複正常.術後3 d,左室舒張末前後徑、左室舒張末期容積均逐漸增大(與術前比較,P<0.05);左室收縮末期容積、左室每搏量及左室射血分數均逐漸增大(P＜0.05).3箇月後左心功能進一步改善,至12箇月時,左心房、左心室大小及左心室功能恢複正常(P＜0.01).隨訪期間,15例齣現心悸癥狀,半年內自愈,無其他併髮癥.結論 ASD介入治療在消除異常分流的同時,有效改善心髒結構和功能,長期療效安全有效.
목적 통과대계발공형방간격결손(ASD)개입치료적원기수방연구,평개기유효성화안전성.방법 선택ASD개입치료적환자61례(남25례,녀36례),우수술전、수술후3 d、3개월、6개월、1、2、5년분별진행수방,포괄순문증상、검사심전도료해유무심률실상;병행초성심동도검사,관찰봉도기상태、잔여분류정황、심장결구、심공능、유무봉도산이위등.결과 술후수방,우심방상하경、좌우경,우심실서장말기좌우경、우심실서장말기용적재술후3 d취명현축소,술후3개월진일보축소(P＜0.05).우심실서장말기장경재술후3개월재명현축소(P＜0.05).술후3개월,우심실서장말기용적、우심실수축말기용적、우심실사혈분수교술전진일보개선,차이구유통계학의의(P＜0.01).술후6개월우심방、우심실대소기본회복정상.술후3 d,좌실서장말전후경、좌실서장말기용적균축점증대(여술전비교,P<0.05);좌실수축말기용적、좌실매박량급좌실사혈분수균축점증대(P＜0.05).3개월후좌심공능진일보개선,지12개월시,좌심방、좌심실대소급좌심실공능회복정상(P＜0.01).수방기간,15례출현심계증상,반년내자유,무기타병발증.결론 ASD개입치료재소제이상분류적동시,유효개선심장결구화공능,장기료효안전유효.
Objective To investigate the long-term follow up of secundum atrial septal defect(ASD) with interventional therapy,and to observe the effects and safety.Methods Sixty-one paitents with secundum ASD(25 male,36 female) underwent transcatheter closure in our hospital.Follow up were made before operation,immediately,3 days,3 months,6 months,1 year,2 years,5 years after operation.The follow up include symptom,electrocardiogram and echocardiography.Results 3 days and 3 months after transcatheter closure,right atrium diameter,right ventricular end-diastolic left-right diameter and right ventricular end-diastolic volume(RVEDV) decreased significantly(P＜0.05).Right ventricular end-diastolic anteroposterior diameter,RVEDV,right ventricular end-systolic volume and right ventricular ejection fraction decreased significantly at 3 months(P＜0.01).At 3-6 months,the right cardiac size is stable on normal level roughly.3 days after transcatheter closure,left ventricular end-diastolic dimension,left ventricular end-diastolic volume,left ventricular end-systolic volume,left ventricular-stroke volume and left ventricular ejection fraction increased significantly(P＜0.05).At one year,the left cardiac size is stable on normal level roughly(P＜0.01).In follow-up period,15 patients had palpitation,self-healing within six months,all patients without any other complications.Conclusions Transcatheter closure of secundum atrial septal defect not only can eliminate the abnormal shunt,but also can improve cardiac dimensions and function.Transcatheter closure of secundum atrial septal defect is effective and safe.
