主动脉瓣成形术治疗儿童主动脉瓣关闭不全的临床效果分析

摘要

Objective To investigate the effect of aortic valvuloplasty on aortic insufficiency in children.Methods Twenty-nine children undergoing aortic valvuloplasty from January 2012 to July 2016 in Capital Medical University,Beijing Anzhen Hospital were enrolled;7 cases had isolated aortic valve insufficiency;12 cases had aortic insufficiency complicated with ventricular septal defect;3 cases had aortic insufficiency complicated with aortior-left ventricular tunnel;7 cases had aortic insufficiency after ventricular septal defect repair.The patients were divided into ＜ 6-year-old group(16 cases) and 6-14-year-old group(13 cases).Operative effect of aortic valvuloplasty was observed;change of left ventricular end-diastolic diameter (LEVDD) after operation was analyzed.Results There was no death;3 children still had mild aortic regurgitation.LEVDDs in both groups significantly decreased 1 week and 3 months after operation compared to those before operation [＜ 6-year-old group:(31 ±6),(31 ±6)mm vs (39 ±7)mm;6-14-year-old group:(39 ±7),(38 ±7) mm vs (46 ±8)mm],the differences were statistically significant (P ＜ 0.05).Conclusion Aortic valvuloplasty has good curative effect on aortic insufficiency in children.%目的 探讨主动脉瓣成形术治疗儿童主动脉瓣关闭不全的效果.方法 选取2012年1月至2016年7月于首都医科大学附属北京安贞医院小儿心脏中心行主动脉瓣成形术治疗的患儿29例,其中单纯主动脉瓣关闭不全7例,合并室间隔缺损12例,伴主动脉左心室通道3例,室间隔缺损修补术后主动脉瓣关闭不全7例.按不同年龄将患儿分为＜6岁组(16例)与6～14岁组(13例).观察主动脉瓣成形术治疗患儿主动脉瓣关闭不全的效果,比较2组患儿术后短期随访左心室舒张末期内径变化.结果 所有患儿无死亡,3例患儿仍有主动脉瓣少量反流,其余患儿均为微量反流或无反流.2组术后1周和3个月左心室舒张末期内径均低于术前[＜6岁组:(31±6)、(31 ±6)mm比(39 ±7)mm;6～14岁组:(39±7)、(38±7)mm比(46 ±8)mm],差异均有统计学意义(均P＜0.05).结论 主动脉瓣成形术治疗儿童主动脉瓣关闭不全效果良好,可作为儿童中重度主动脉瓣关闭不全的首选治疗手段.