中国循环杂志
中國循環雜誌
중국순배잡지
CHINESE CIRCULATION JOURNAL
2014年
11期
907-909
,共3页
王志民%李永青%郑宏%孙鑫%段福建%朱振辉%徐仲英%王剑鹏%肖明虎%王浩
王誌民%李永青%鄭宏%孫鑫%段福建%硃振輝%徐仲英%王劍鵬%肖明虎%王浩
왕지민%리영청%정굉%손흠%단복건%주진휘%서중영%왕검붕%초명호%왕호
房间隔缺损%经皮封堵%超声心动图
房間隔缺損%經皮封堵%超聲心動圖
방간격결손%경피봉도%초성심동도
Atrial septal defect%Occlude%Echocardiography
目的：研究超声心动图在多发房间隔缺损（ASD）封堵术中的应用价值。<br> 方法：应用经胸超声心动图（TTE）及经食管超声心动图（TEE）筛选多发继发孔型ASD患者，在X线及TTE观测下行经皮ASD封堵手术，术后24小时、1个月、3个月、半年行TTE及心电图检查、X线胸片评价疗效。共筛查出42例多发ASD患者，其中38例为双孔ASD患者，3例为中央型筛孔型ASD，1例3孔ASD，男17例，女25例，年龄3~52岁，平均年龄约（32.6±13.4）岁。<br> 结果：采用心尖四腔心切面、胸骨旁大动脉短轴切面及剑下双房心切面测量ASD的大小及间隔距离，大孔上下径9~27 mm[平均（20.7±6.1）mm]，前后径8~23 mm[平均（16.9±5.7）mm]，小孔上下径3~12 mm[平均（6.8±3.6） mm]，二者相距4~18 mm[平均（7.9±2.6）mm]。4例双孔间距超过7 mm的双孔ASD患者（间距为8.7 mm）应用两个封堵器分别封堵两个孔，术后无分流。其他38例采用一个封堵器封堵，封堵器采用14~36 mm进口或国产Amplatzer封堵器，平均约（25.1±6.4）mm，比超声测量值大约（6.9±1.7）mm，均为封堵大孔，手术封堵成功率100%，术后残余分流17例，残余分流率约占40.5%。术后随访6~36个月，平均18.7个月，随访三个月后仅有11例有少量残余分流，占26.2%。<br> 结论：超声心动图对病例的选择、封堵器的型号选择、术中监测、术后疗效评价等方面均有重要的作用。
目的：研究超聲心動圖在多髮房間隔缺損（ASD）封堵術中的應用價值。<br> 方法：應用經胸超聲心動圖（TTE）及經食管超聲心動圖（TEE）篩選多髮繼髮孔型ASD患者，在X線及TTE觀測下行經皮ASD封堵手術，術後24小時、1箇月、3箇月、半年行TTE及心電圖檢查、X線胸片評價療效。共篩查齣42例多髮ASD患者，其中38例為雙孔ASD患者，3例為中央型篩孔型ASD，1例3孔ASD，男17例，女25例，年齡3~52歲，平均年齡約（32.6±13.4）歲。<br> 結果：採用心尖四腔心切麵、胸骨徬大動脈短軸切麵及劍下雙房心切麵測量ASD的大小及間隔距離，大孔上下徑9~27 mm[平均（20.7±6.1）mm]，前後徑8~23 mm[平均（16.9±5.7）mm]，小孔上下徑3~12 mm[平均（6.8±3.6） mm]，二者相距4~18 mm[平均（7.9±2.6）mm]。4例雙孔間距超過7 mm的雙孔ASD患者（間距為8.7 mm）應用兩箇封堵器分彆封堵兩箇孔，術後無分流。其他38例採用一箇封堵器封堵，封堵器採用14~36 mm進口或國產Amplatzer封堵器，平均約（25.1±6.4）mm，比超聲測量值大約（6.9±1.7）mm，均為封堵大孔，手術封堵成功率100%，術後殘餘分流17例，殘餘分流率約佔40.5%。術後隨訪6~36箇月，平均18.7箇月，隨訪三箇月後僅有11例有少量殘餘分流，佔26.2%。<br> 結論：超聲心動圖對病例的選擇、封堵器的型號選擇、術中鑑測、術後療效評價等方麵均有重要的作用。
목적：연구초성심동도재다발방간격결손（ASD）봉도술중적응용개치。<br> 방법：응용경흉초성심동도（TTE）급경식관초성심동도（TEE）사선다발계발공형ASD환자，재X선급TTE관측하행경피ASD봉도수술，술후24소시、1개월、3개월、반년행TTE급심전도검사、X선흉편평개료효。공사사출42례다발ASD환자，기중38례위쌍공ASD환자，3례위중앙형사공형ASD，1례3공ASD，남17례，녀25례，년령3~52세，평균년령약（32.6±13.4）세。<br> 결과：채용심첨사강심절면、흉골방대동맥단축절면급검하쌍방심절면측량ASD적대소급간격거리，대공상하경9~27 mm[평균（20.7±6.1）mm]，전후경8~23 mm[평균（16.9±5.7）mm]，소공상하경3~12 mm[평균（6.8±3.6） mm]，이자상거4~18 mm[평균（7.9±2.6）mm]。4례쌍공간거초과7 mm적쌍공ASD환자（간거위8.7 mm）응용량개봉도기분별봉도량개공，술후무분류。기타38례채용일개봉도기봉도，봉도기채용14~36 mm진구혹국산Amplatzer봉도기，평균약（25.1±6.4）mm，비초성측량치대약（6.9±1.7）mm，균위봉도대공，수술봉도성공솔100%，술후잔여분류17례，잔여분류솔약점40.5%。술후수방6~36개월，평균18.7개월，수방삼개월후부유11례유소량잔여분류，점26.2%。<br> 결론：초성심동도대병례적선택、봉도기적형호선택、술중감측、술후료효평개등방면균유중요적작용。
Objective: To evaluate the effect of echocardiography for occluding the multiple seconded atria1 septal defects ( MASD) in relevant patients. <br> Methods: A total of 42 MASD patients were selected by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE). The transcatheter closure was monitored by TTE and X-ray, the effect of treatment was evaluated by TTE, ECG and chest X-ray at 24 hours and 1, 3, 6 months after the procedure. There were 38 patients with 2 defects, 3 with many central small defects and 1 with 3 defects. The patients included 17 male and 25 female with the mean age of (32.6 ± 13.4) years. <br> Results: The size and distance of the defects were measured with 4 cardiac chambers cross sectional study. The mean diameter of bigger defect from up to down was (9-27) mm, with the mean of (20.7 ± 6.1) mm, from front to back was (8-23) mm, with the mean of (16.9 ± 5.7) mm;the mean diameter of small defect from up to down was (3-12) mm, with the mean of (6.8 ± 3.6) mm. The length of the defect interva1 was (4-18) mm, with the mean of (7.9 ± 2.6) mm. There were 4 patients with 2 defect interval at 8.7 mm who received 2 occluders without post-operative lfow shunt. The rest 38 patients received 1 Amplatzer occluder which was (14-36) mm with the mean of (25.1 ± 6.4) mm which was (6.9 ± 1.7) mm larger than echocardiographic prediction. The success rate of implantation was 100%. There were 17 (40.5%) patients with post-operative lfow shunt. The patients were followed-up for (6-36) months, with the mean of 18.7 months, there were 11 (26.2%) patients with small amount of lfow shunt at 3 months after the operation. <br> Conclusion: Echocardiography is important for choosing the type and size of occluder devices, in-operative monitoring and post-operative effect evaluation for treating the ASD patients.
