经皮球囊肺动脉瓣膜成形术治疗小儿肺动脉瓣狭窄

Effects of Percutaneous Balloon Pulmonary Valvuloplasty on Children With Congenital Pulmonic Valvular Stenosis

目的探讨经皮球囊肺动脉瓣膜成形术(percutaneous balloon pulmonary valvuloplasty,PBPV)治疗小儿先天性肺动脉瓣狭窄(pulmonic valvular stenosis,PS)的临床疗效。方法选择1996年3月至2006年12月,在肇庆市第一人民医院儿科与佛山市第一人民医院儿科确诊为单纯先天性肺动脉瓣狭窄16例患儿为研究对象。根据患儿的年龄和肺动脉瓣狭窄程度,9例患儿选择单球囊法,7例采用双叶球囊法进行瓣膜扩张术(本研究遵循的程序符合肇庆市第一人民医院和佛山市第一人民医院人体试验委员会所制定的伦理学标准,得到该委员会批准,取得试验患儿监护人的知情同意,并与其签署临床研究知情同意书)。结果16例患儿行经皮球囊肺动脉瓣膜成形术后,即时跨瓣压力阶差(transvalvular pressure gradient,ΔP)均显著下降,与术前比较,差异有显著意义(t=4.13,P<0.05)。结论经皮球囊肺动脉瓣膜成形术是简便、安全、经济的治疗小儿先天性肺动脉瓣狭窄的首选方法。

Objective To explore the clinical effects of percutaneous balloon pulmonary valvuloplasty （PBPV） on the treatment of congenital pulmonary valvular stenosis （PS） in children. Methods From March 1996 to December 2006, 16 children were diagnosed as pulmonary valvular stenosis in the First People＇s Hospital of Zhaoqing and First People＇s Hospital of Foshan. They were performed by percutaneous balloon pulmonary valvuloplasty using one balloon （n= 9） or dual balloon （n= 7） according to their age and degrees of pulmonary valvular stenosis. Informed consent was obtained from all participants. Results There were remarkable declines in post ballooning residual transvalvular pressure gradient （△P） after the percutaneous balloon pulmonary valvuloplasty on 16 children. There had significant difference between post- ballooning and pre ballooning in transvalvular pressure gradient （t = 4.13, P 〈 0. 05）. Conclusion Percutaneous balloon pulmonary valvutoplasty operation is simple and safe, which should be the first choice for children with pulmonary valvular stenosis.