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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[1] 林水华,谢薇,雷婷,等.超声测量封堵器伸展径和厚度在房间隔缺损介入治疗中的价值[J].中国医药科学,2016,6(12):163. [2] 中国医师协会心血管内科分会先心病工作委员会.常见先天性心脏病介入治疗中国专家共识[J].介入放射学杂志,2011,20(1):3. [3] 泮思林,邢泉生,孙慧文,等.应用室间隔缺损封堵器治疗婴幼儿粗大动脉导管未闭[J].中国介入影像与治疗学,2010,7(2):137. [4] SEO JS,SONG JM,KIM YH,et al.Effect of atrial septal defect shape evaluated using three-dimensional transesophageal chocardiography on size measurements for percutaneous closure[J].J Am Soc Echocardiogr,2012,25(10):1031. [5] 周陵,谢渡江,李小波.老年房间隔缺损的介入治疗[J].实用老年医学,2012,26(5):365. [6] 蒲俊舟,李铁铮,吴文辉,等.改良输送鞘通过法行房间隔缺损封堵术100例临床分析[J].中国介入心脏病学杂志,2014,14(6):702. [7] 张晓红,陈颖,朱丹茹,等.超声心动图评价房间隔缺损封堵术后左、右心形态及功能的改变[J].中国实用医刊,2013,40(18):16. [8] 王玥,崔文姬,杨军,等.单心动周期实时三维超声心动图评价房间隔缺损患者右心室收缩功能[J].中国医学影像学杂志,2013,21(4):264. [9] YANG CT,LIN MT,JAW FS,et al.Trends in the utilization of computed tomography and cardiac catheterization among children with congenital heart disease[J].J Form Med Assoc,2014,114(11):1061. [10] 蒲俊舟,吴文辉,李铁铮,等.房间隔膨出瘤合并房间隔缺损介入治疗的临床经验[J].心肺血管病杂志,2015,34(3):177. [11] ERDEM A,SARITAS T,ZEYBEK C,et al.Transthoracic echocardiographic guidance during transcatheter closure of atrial septal defects in children and adults[J].Int J Cardiovasc Imaging,2013,29(1):53. [12] 丁寻实,汪汉,蔡琳.常用超声介导房间隔缺损封堵方法的优缺点比较[J].心血管病学进展,2013,34(6):823. [13] 欧阳文斌,潘湘斌,冯坤静,等.单纯食管超声引导经皮封堵治疗房间隔缺损[J].中华实用儿科临床杂志,2014,29(18):1425. [14] 梁永梅,金梅,王霄芳,等.介入治疗房间隔缺损600例临床分析[J].心肺血管病杂志,2014,33(4):486. [15] 陈梅,吴俊,薛念余,等.超声心动图对肺动脉高压的诊断价值分析[J].现代实用医学,2014,26(11):1442. -
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