CAJ | 학술논문

目的分析先天性心脏病继发孔型房间隔缺损介入封堵术后发生残余分流的原因、防治措施及估测预后.方法使用经胸、经食管超声心动图的二维及三维成像,对2010年8月至2013年8月首都医科大学附属北京安贞医院56例房间隔缺损介入封堵术治疗后发生残余分流的患者进行回顾性分析.结果 56例患者中男性18例,女性38例,其中单发性房间隔缺损46例(82.1％),多发性房间隔缺损10例(17.9％);术后微量残余分流的患者32例(57.1％),少量残余分流的患者22例(39.3％),中量残余分流的患者2例(3.6％),检出的残余分流以微量残余分流为主;患者残余分流在术后即刻被检出的有45例(80.3％),术后3d复查时检出的有9例(16.1％),3个月复查时检出的有1例(1.8％),6个月复查时检出的有1例(1.8％).结论房间隔缺损介入封堵术后残余分流出现的原因大多是术前未能准确评估房间隔缺损的数目、大小、形态、解剖毗邻及边缘的软硬程度.三维超声心动图能够提供三维立体图像,能更准确地反映房间隔缺损的形态结构,可为临床提供更为迅速有效的信息.
목적 분석선천성심장병계발공형방간격결손개입봉도술후발생잔여분류적원인、방치조시급고측예후.방법 사용경흉、경식관초성심동도적이유급삼유성상,대2010년8월지2013년8월수도의과대학부속북경안정의원56례방간격결손개입봉도술치료후발생잔여분류적환자진행회고성분석.결과 56례환자중남성18례,녀성38례,기중단발성방간격결손46례(82.1％),다발성방간격결손10례(17.9％);술후미량잔여분류적환자32례(57.1％),소량잔여분류적환자22례(39.3％),중량잔여분류적환자2례(3.6％),검출적잔여분류이미량잔여분류위주;환자잔여분류재술후즉각피검출적유45례(80.3％),술후3d복사시검출적유9례(16.1％),3개월복사시검출적유1례(1.8％),6개월복사시검출적유1례(1.8％).결론 방간격결손개입봉도술후잔여분류출현적원인대다시술전미능준학평고방간격결손적수목、대소、형태、해부비린급변연적연경정도.삼유초성심동도능구제공삼유입체도상,능경준학지반영방간격결손적형태결구,가위림상제공경위신속유효적신식.
Objective To retrospectively analyze the reasons and preventive measures for residual shunts after successful transcatheter closure of atrial septal defects.Methods Between August 2010 and August 2013,fifty-six patients with atrial septal defects who underwent transcatheter atrial septal defects closure were detected for residual shunt and retrospectively analyzed.Results A total of the 56 atrial septal defects,including 18 male and 38 female.46(82.1％)had single atrial septal defects and 10(17.9％) had multiple atrial septal defects.In patients with residual shunts,the patients with trace residual shunts were 32 (57.1％) ; small amounts of residual shunts were 22(39.3％);moderate amounts residual shunt were 2 (3.6％)and trace residual shunts were in the majority.The residual shunt that was detected after the transcatheter closure were 45 (80.3％) ; the residual shunt that was detected after 3 days were 9(16.1％) ;the residual shunt that was detected after 3-month was 1 (1.8％) ;the residual shunt that was detected after 6-month was 1 (1.8％).Conclusions The causes of residual shunt after the transcatheter closure of atrial septal defects do not accurately estimate the defect size,morphology,surrounding structures and degree of soft and hard edge.Three-dimensional echocardiography can more accurately identify atrial septal defects shape and provide more accurate indexto guide transcatheter device implantation than two dimensional echocardiography.