CAJ | 학술논문

目的：探讨室间隔缺损经导管封堵术后传导阻滞的发生率及危险因素。方法：回顾性分析1069例室间隔缺损封堵患者的临床随访资料。采用多因素Logistic 回归分析术后发生传导阻滞的危险因素。结果：随访中位时间2．2（1～4．16）年。术后早期出现传导阻滞219例（20．5％），严重传导阻滞35例（3．3％）。随访期间，出现迟发传导阻滞43例（4．0％），其中完全性房室传导阻滞4例（0．4％）。多因素Logistic回归分析显示：使用偏心型封堵器、手术时间长、使用进口封堵器是术后早期出现严重房室传导阻滞的危险因素；使用小腰大边型封堵器是迟发传导阻滞的危险因素。结论：室间隔缺损经导管封堵术后早期传导阻滞常见，多为轻微可逆。而迟发严重房室传导阻滞少见。行经导管封堵术的室间隔缺损操作时间不宜过长，尽可能选择对称型封堵器。
목적：탐토실간격결손경도관봉도술후전도조체적발생솔급위험인소。방법：회고성분석1069례실간격결손봉도환자적림상수방자료。채용다인소Logistic 회귀분석술후발생전도조체적위험인소。결과：수방중위시간2．2（1～4．16）년。술후조기출현전도조체219례（20．5％），엄중전도조체35례（3．3％）。수방기간，출현지발전도조체43례（4．0％），기중완전성방실전도조체4례（0．4％）。다인소Logistic회귀분석현시：사용편심형봉도기、수술시간장、사용진구봉도기시술후조기출현엄중방실전도조체적위험인소；사용소요대변형봉도기시지발전도조체적위험인소。결론：실간격결손경도관봉도술후조기전도조체상견，다위경미가역。이지발엄중방실전도조체소견。행경도관봉도술적실간격결손조작시간불의과장，진가능선택대칭형봉도기。
Objective To study the prevalence and risk factors of heart conduct block after transcatheter closure of ventricular septal defect (VSD)surgery. Methods A total of 1 069 cases underwent transcatheter closure VSD were retrospectively analyzed. The risk factors were assessed by multivariable logistical analysis. Results The median follow-up time was 2.2 (1 to 4.16) years. The early post-procedure heart conduct block was 20.5 %(219 cases), and 35 cases underwent severe conduct block (3.3%). During the follow-up, there were 43 late onset heart conduct block (4.0%), including 4 (0.4%) complete atrioventricular block. Multivariable logistic analysis showed that implanted of asymmetrical occluder from foreign company was the risks factors for early onset severe conduct block, with longer procedure time. Placement of thin-waist-big-side occluder were risk factor for the late onset conduct block. Conclusions Heart conduct block after transcatheter closure VSD is common , light and recovery. The late onset severe conduct block is minor. Symmetrical occluder should be chosen in transcatheter closure VSD if possible.