CAJ | 학술논문

目的通过与传统放射线引导方法相比较,评价单纯经食道超声(TEE)引导在经皮介入封堵儿童房间隔缺损中的早期临床应用效果.方法收集2012年10月至2014年1月单纯TEE引导下经皮房间隔缺损封堵患儿50例(TEE组),均采用TEE引导并监测封堵全过程.选取同期传统放射线引导下经皮房间隔缺损封堵患儿162例为对照组.2组患者均于术后1个月在门诊随访,并行经胸超声心动图检查.结果 2组患儿年龄、体质量、房间隔缺损直径、封堵器直径、手术时间及住院时间无明显差异.TEE组和对照组封堵器置入成功率分别为100.0％和97.5％,2组比较差异无统计学意义(P=0.58);术后即刻残余分流发生率分别为0和4.4％,2组比较差异无统计学意义(P=0.20);气管插管时间分别为(2.9±0.5)h和0.术后随访1个月,2组患者均无残余分流,未发生外周血管损伤、心脏穿孔、封堵器脱落等严重并发症.结论单纯TEE引导下经皮介入封堵儿童房间隔缺损不仅能够完全避免放射线及对比剂,而且保持了传统经皮介入治疗安全、微创的优点.
목적 통과여전통방사선인도방법상비교,평개단순경식도초성(TEE)인도재경피개입봉도인동방간격결손중적조기림상응용효과.방법 수집2012년10월지2014년1월단순TEE인도하경피방간격결손봉도환인50례(TEE조),균채용TEE인도병감측봉도전과정.선취동기전통방사선인도하경피방간격결손봉도환인162례위대조조.2조환자균우술후1개월재문진수방,병행경흉초성심동도검사.결과 2조환인년령、체질량、방간격결손직경、봉도기직경、수술시간급주원시간무명현차이.TEE조화대조조봉도기치입성공솔분별위100.0％화97.5％,2조비교차이무통계학의의(P=0.58);술후즉각잔여분류발생솔분별위0화4.4％,2조비교차이무통계학의의(P=0.20);기관삽관시간분별위(2.9±0.5)h화0.술후수방1개월,2조환자균무잔여분류,미발생외주혈관손상、심장천공、봉도기탈락등엄중병발증.결론 단순TEE인도하경피개입봉도인동방간격결손불부능구완전피면방사선급대비제,이차보지료전통경피개입치료안전、미창적우점.
Objective To investigate the early clinical effects of using transesophageal echocardiography (TEE) in order to guide percutaneous transcatheter closure of atrial septal defect in children in comparison to fluoroscopy.Methods From Oct.2012 to Jan.2014,50 cases of consecutive children (TEE group) undergoing percutaneous transcatheter closure of atrial septal defect received the procedure completely guided and monitored by TEE.One hundred and sixty-two children who guided by conventional fluoroscopy during the same period served as controls.After 1 month of the operation,patients of 2 groups were followed up by conducting transthoracic echocardiography.Results The mean age,mean body weight,the mean size of atrial septal defect and occlusion,procedure time,and hospital stay time had no statistical differences between 2 groups.In comparison with the TEE group and control group,there were no differences in the rate of successful occlusion (100.0％ vs 97.5％,P =0.58) and immediate postoperative residual shunt (0 vs 4.4％,P =0.20).The TEE group required general anesthesia intubation time lasted (2.9 ± 0.5) h and the control group was spontaneously breathing under sedation.During 1 month follow-up,there were no complications such as residual shunt,peripheral vascular injury,cardiac perforation or occluder abscission in all patients.Conclusions Percutaneous transcatheter closure of atrial septal defect completely guided by TEE is safe and minimally invasive in children.The procedure can avoid the injuries of radiation and contrast agent.Its effect can compete with that by using traditional fluoroscopy.