经皮二尖瓣球囊成形术房间隔穿刺定位的方法学探讨

Methodological Study on Localization of the Transseptal Puncture Point in Percutaneous Balloon Mitral Valvuloplasty

房间隔穿刺导致心肌穿孔是经皮二尖瓣球囊成形术（PBMV）最为严重的并发症之一。本文66例接受PBMV的患者中，A组21例采用Inoue定位法穿刺间隔，2例发生穿刺针及外鞘管误入心包腔，造成急性心包填塞，心肌穿孔率9．5％；B组45例采用笔者提出改良的左房综合定位法穿刺房间隔全部获得成功，心肌穿孔率0％。此法应用于临床效果满意，其定位的精确度和到位的可靠性是可以信赖的。

Cardiac Perforation resulting from transseptal puncture is one of the most serious complications of percutaneous balloon ndtral valvuloplasty (PBMV ). In this study, 66 patients who received PBMV were divided into two groups according to the metheds of localizing transseptal puncture POint. Group A included 21 patients in whom the Inone method was used, and group B included the remaining 45 patients in whom the modified comprehensive localization method invented by us was used. The results showed that: in group A, cardiac Perforation occurred in 2(9.5%) patients becanse puncture needle and sheath accidentall entered the percardiac cavityl in group B, transseptal puncture was successful in all patients (cardiac Perforation rate was 0%) (P＜0.001). We conclde that the result of modified comPrehesive localization is satisfactory, and the precision of localization and reliability of approach is credible.