国产封堵器介入治疗先天性心脏病的临床研究

摘要

目的：分析研究经导管植入国产封堵器在先天性心脏病介入治疗中的临床疗效。方法选择2005年4月—2012年10月在该院使用国产封堵器介入治疗先天性心脏病患者134例，所有患者均经临床、心电图及经胸超声心动图检查确诊并有行介入封堵治疗的适应证。房间隔缺损患者均经股静脉穿刺行右心导管检查及送入封堵器械，动脉导管未闭和室间隔缺损需经股动脉穿刺，封堵前行主动脉弓降部或左室造影以进一步明确诊断和适应证，帮助选择封堵器的型号，术后重复造影以判断封堵效果，所有患者均使用国产封堵器及其配套输送系统。封堵后随访1~24个月。结果手术成功率97.76%(131/134)，无心脏瓣膜受损、封堵器脱落移位。释放封堵器后残余分流约1.49%(2/134)，Ⅲ度房室传导阻滞0.74%(1/134)。随防中未发现血栓形成、组织排异反应、细胞毒性及急性全身中毒现象。结论先天性心脏病介入治疗具有成功率高、创伤小、并发症低，操作简单，疗效确切，恢复快等特点，是治疗先天性心脏病的理想手段之一。%Objective To investigate the efficacy of interventional therapy versus surgery for the treatment of congenital heart dis-ease(CHD). Methods From April 2005 to October2012.134 cases of congenital heart disease were treated with our hospital. All of the patients were confirmed by clinical,electrocardiogram and transthoracic echocardiography diagnosis and subjected to examina-tion in treatment of indication.All patients underwent femoral venipuncture catheterization examination to insert the occluder. Patent ductus arteriosus and ventricular septal defecl needed femoral artery puncture operation.Aortic arch descending part or left ventricular ventriculography was performed before occlusion to further cladfy the diagnosis and surgical indications and help chooseoccluder type. Angiography was repeated after surgery to judge the effect.The surgery was performed using China-made o-coluder and conveying system.The patients were followed up for 1 month to 24 months. Results Surgical successrate was 97.76%(131/134).With no damage to the heart valve or occluder dislocation;residuaf shunt was1.49%(2/134)after releasing the occluder, degreeⅢatrioventricular block occurred in 0.74%(1/134). No thrombosis,rejection,acute systemic toxicity or cell toxicity was found. Conclusion Chinese made domestic occluder device to treat congenital heart diseases is effective and safe ,and has high success rate.