经皮介入治疗儿童先天性心脏病并发症临床分析

摘要

目的 分析总结儿童先天性心脏病(CHD)经皮介入治疗的并发症的发生率、危险因素及处理方法.方法 回顾性分析安徽省儿童医院2010年8月至2016年6月行CHD介入治疗379例患儿的临床资料.按照病种分为5组:房间隔缺损(ASD)组108例、室间隔缺损(VSD)组34例、动脉导管未闭(PDA)组182例、肺动脉瓣狭窄(PVS)组45例、复合先天性心脏病(cCHD)组10例,统计分析各组并发症的发生率、危险因素及其处理方法.结果 总体手术成功率98.94％,无死亡病例.共有19例患儿发生并发症,发生率为5.02％;ASD组为4.62％,VSD组为12.13％,PDA组为4.39％,PVS组为2.22％,cCHD组为10.00％.其中有7例患儿发生严重并发症,发生率为1.85％.并发症组与无并发症组年龄、病种比较差异无统计学意义(P＞0.05).发生并发症的患儿经手术和保守治疗后均恢复良好,平均随访7.5个月,随访期间未出现新的并发症.结论 儿童CHD介入治疗并发症发生率低,患儿年龄和病种不是影响并发症发生的危险因素.%Objective To analyze the incidence,risk factors and management of complications associated with percutaneous intervention in those chiltren with congenital heart disease (CHD).Methods The clinical data of 379 children with CHD,underwent intervention therapies in our hospital between Aug 2010 and Jun 2016,were retrospectively analyzed.According to the type of illness,all patients were divided into 5 groups:the atrial septal defect (ASD) group of 108 cases,the ventricular septal defect (VSD) group of 34 cases,the patent ductus arteriosus (PDA) group of 182 cases,the pulmonary valve stenosis (PVS) group of 45 cases and the combined CHD (cCHD) group of 10 cases.And the incidence,risk factors and management of complications in each group were recorded and analyzed.Results The general successful rate of intervention therapy was 98.94％,with no outcome of death.There were 19 children who had complications,with an incidence rate of 5.02％,and in the ASD,VSD,PDA,PVS and cCHD group,the complication rate was 4.62％,12.13％,4.39％,2.22％ and 10.00％,respectively.Severe complications were found in 7 children,accounting for 1.85％.There was no significant difference between the complication group and the noncomplication group in the age and disease(P ＞ 0.05).The children having experienced complications recovered well after surgery and conservative treatment,with no new complication during the average follow-up period of 7.5 months.Conclusion The incidence of complications of intervention therapy is relatively low in those CHD patients,and the age and disease of patients are not risk factors affecting occurrence of complications.