超声测量封堵器伸展径和厚度对先天性心脏病介入治疗的临床价值
Clinical value of ultrasound measuring the extension diameter and thickness of occluder in interventional treatment of congenital heart disease
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摘要: 目的：探讨超声测量封堵器伸展径和厚度对先天性心脏病（先心病）介入治疗的临床价值。方法：回顾性分析90例先心病行封堵器治疗病人，根据《常见先天性心脏病介入治疗中国专家共识》分为标准组（67例，选择的封堵器型号遵循专家共识）和非标准组（23例，选择的封堵器型号不遵循专家共识），2组均采用超声测量封堵器伸展径和厚度，比较2组病人的手术时间、超声检查时间、血流动力学，超声检查封堵器伸展径、厚度及位置变化等情况。结果：2组病人超声检查时间、肺循环血量/体循环血量和肺动脉平均压差异均无统计学意义（P>0.05），标准组的手术时间低于非标准组（P<0.05）。标准组术后第2天、术后3个月的封堵器伸展径、缺损最大径均明显降低（P<0.01），非标准组术后3个月明显降低（P<0.01）；标准组术后第2天和术后3个月的封堵器伸展径、缺损最大径低于非标准组（P<0.05~P<0.01）。先心病中房间隔缺损封堵器型号16~30 mm者的封堵器厚度大于≤ 15 mm型号者（P<0.01）。2组病人放置封堵器3个月后，非标准组封堵器出现向左心房移位和总的位置变化的比例均高于标准组（P<0.05和P<0.01）。结论：超声能够比较准确、简便地测量先心病病人封堵器伸展径及厚度，同时还能有效监测封堵器形变过程，评估封堵器的临床治疗效果和术后状态。Abstract: Objective:To investigate the clinical value of ultrasound measuring the extension diameter and thickness of occluder in interventional treatment of congenital heart disease(CHD).Methods:The clinical data of 90 patients treated with occluder were retrospectively analyzed.The patients were divided into the standard group(67 cases treated with occluder model followed by the consensus of experts) and non-standard group(23 cases treated with occluder model no followed by the consensus of experts) according to "common congenital heart disease interventional Chinese experts consensus".The operation time,ultrasonic examination time,hemodynamics,ultrasound measuring the extension diameter and thickness of occluder,and position of the occluder between two groups were compared.Results:There were no statistical significances in the ultrasonography time,pulmonary blood volume/systemic blood volume and pulmonary artery mean pressure between two groups(P>0.05),and the operation time in standard group was lower than that in non-standard group(P<0.05).After 2 days and 3 months of operation,the extension diameter and maximum defect diameter of occluder in standard group and after 3 months of operation in non-standard group significantly decreased(P<0.01).After 2 days and 3 months of operation,the extension diameter and maximum defect diameter of occluder in standard group were less than those in non-standard group(P<0.05 to P<0.01).The thickness of the atrial septal defect occluder type 16 to 30 mm in CHD disease was more than that in occluder type ≤ 15 mm(P<0.05).After 3 months of placing occluder,the rates of left atrium shift and total position change of occluder in non-standard group were higher than those in standard group(P<0.05 and P<0.01).Conclusions:Ultrasound can accurately and easily measure the extension diameter and thickness of occluder,effectively monitor the occluder deformation process,and assess the clinical efficacy of occluder and postoperative status.
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Key words:
- congenital heart disease /
- echocardiography /
- interventional therapy /
- occluder
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