经食道超声在经股静脉途径房间隔缺损介入封堵术中的应用价值
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摘要
目的探讨经食道超声在经股静脉途径房间隔缺损介入封堵术中的应用价值。方法回顾性分析2017年10月-2018年10月期间在宁夏医科大总院心脑血管病医院行经股静脉途径房间隔缺损介入封堵术65例患者的临床资料,根据手术方式不同将其分为超声组(35例)与传统组(30例)。比较分析两组患者的封堵器直径、手术时间、术后住院时间、封堵成功率、残余分流发生率及并发症发生情况。结果超声组与传统组封堵器直径、封堵成功率差异均无统计学意义(P均>0.05);超声组的手术时间及术后住院时间均短于传统组(P<0.05),残余分流率、并发症发生率低于传统组(P均<0.05)。两组患者均未发生封堵器移位脱落、心脏穿孔、死亡等。结论经食道超声引导下经股静脉途径房间隔介入封堵术疗效确切,手术时间短、封堵成功率高、术后恢复快、并发症发生率低,值得在临床上推广应用。
Objective To investigate the value of transesophageal ultrasound in the interventional closure of the atrial septal defect through the femoral vein. Methods A retrospective analysis of 65 patients with atrial septal defect in our hospital from October 2017 to October 2018 was performed. The clinical data were divided into ultrasound group according to different surgical methods(35 cases)and the traditional group(30 cases). The occlusion device diameter,operation time,postoperative hospital stay,success rate of closure,residual shunt rate and complications were compared between the two groups. Results There was no significant difference between the ultrasound group and the traditional group in occluder diameter and sealing success rate(P>0.05). The operation time and postoperative hospital stay of the ultrasound group were significantly shorter than that of the traditional group,and the residual shunt rate was significantly lower than the traditional group(P<0.05). The incidence of complications in the ultrasound group was significantly lower than that in the conventional group(P<0.05). There was no occluder displacement,cardiac perforation,and death in both groups. Conclusion Transesophageal ultrasound guided transsphenoidal approach for atrial septal occlusion is effective,with short operation time,high success rate of closure,rapid postoperative recovery and low complication rate. It is worthy of clinical application.
Objective To investigate the value of transesophageal ultrasound in the interventional closure of the atrial septal defect through the femoral vein. Methods A retrospective analysis of 65 patients with atrial septal defect in our hospital from October 2017 to October 2018 was performed. The clinical data were divided into ultrasound group according to different surgical methods(35 cases)and the traditional group(30 cases). The occlusion device diameter,operation time,postoperative hospital stay,success rate of closure,residual shunt rate and complications were compared between the two groups. Results There was no significant difference between the ultrasound group and the traditional group in occluder diameter and sealing success rate(P>0.05). The operation time and postoperative hospital stay of the ultrasound group were significantly shorter than that of the traditional group,and the residual shunt rate was significantly lower than the traditional group(P<0.05). The incidence of complications in the ultrasound group was significantly lower than that in the conventional group(P<0.05). There was no occluder displacement,cardiac perforation,and death in both groups. Conclusion Transesophageal ultrasound guided transsphenoidal approach for atrial septal occlusion is effective,with short operation time,high success rate of closure,rapid postoperative recovery and low complication rate. It is worthy of clinical application.
引文
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[10]卢衡,陈良万,张贵灿,等.超声心动图引导下经皮房间隔缺损封堵术的临床评估[J].中南大学学报(医学版),2015,40(6):646-650.
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[12]吴红兵,宋宏宁,王志维,等.经食道超声引导下经胸微创房间隔缺损封堵术治疗继发孔中央型房间隔缺损的效果[J].广西医学,2018,40(22):2661-2662.
[13]潘湘斌,逄坤静,胡盛寿,等.经食管超声心动图引导下介入治疗房间隔缺损幼儿的有效性和安全性[J].中华心血管病杂志,2013,41(9):744-766.
[14] Hongxin L,Wenbin G,Lijun S,et al. Intraoperative device closure of secundum atrial septal defect using a fight anterior minithoracotomy in 100 patients[J].J Thorac Cardiovasc Surg,2017,134(22):946-951.
[15]杨学永,周启宇,王振国,等.不同微创介入治疗在房间隔缺损中的应用[J].实用儿科临床杂志,2012,27(13):1044-1045.
[2]曹海根,王金锐.实用腹部超声诊断学[M].北京:人民卫生出版社,2006.
[3]中华儿科杂志编辑委员会.先天性心脏病经导管介入治疗指南[J].中华儿科杂志,2004,42(3):234-239.
[4]林艳端,阎国辉,张绍洁,等.经食管三维超声在心血管疾病手术中的应用价值[J].临床超声医学杂志,2016,18(7):463-466.
[5]张戈军,徐仲英,蒋世良,等.第二代Amplatzer动脉导管未闭封堵器经股动脉逆行插管行室间隔缺损封堵术疗效评价[J].临床荟萃,2015,30(6):601-604.
[6]陈林峰,孙勇,陈江华.经食道三维超声心动图指引行经皮房间隔缺损封堵术87例临床分析[J].福建医药杂志,2018,40(2):98-99.
[7]欧阳文斌,潘湘斌,逄坤静,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):1425-1427.
[8] Dalvi B,Sheth K,Jain S,et al. Transcatheter closure of large atrial septal defects using 40 mm amplatzer septal occluder:single group experience with short and intermediate term follow-up[J]. Cathet Cardiovasc Intervent,2017,89(6):1035-1043.
[9]逄坤静,王浩,孟红,等.经胸二维超声心动图引导儿童房间隔缺损经皮封堵治疗术[J].中华超声影像学杂志,2014,23(7):573-576.
[10]卢衡,陈良万,张贵灿,等.超声心动图引导下经皮房间隔缺损封堵术的临床评估[J].中南大学学报(医学版),2015,40(6):646-650.
[11] Kleinerman RA. Cancer risks following diagnostic and therapeutic radiation exposure in children[J].Pediatr Radiol,2006,36(2):121-125.
[12]吴红兵,宋宏宁,王志维,等.经食道超声引导下经胸微创房间隔缺损封堵术治疗继发孔中央型房间隔缺损的效果[J].广西医学,2018,40(22):2661-2662.
[13]潘湘斌,逄坤静,胡盛寿,等.经食管超声心动图引导下介入治疗房间隔缺损幼儿的有效性和安全性[J].中华心血管病杂志,2013,41(9):744-766.
[14] Hongxin L,Wenbin G,Lijun S,et al. Intraoperative device closure of secundum atrial septal defect using a fight anterior minithoracotomy in 100 patients[J].J Thorac Cardiovasc Surg,2017,134(22):946-951.
[15]杨学永,周启宇,王振国,等.不同微创介入治疗在房间隔缺损中的应用[J].实用儿科临床杂志,2012,27(13):1044-1045.