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肥厚型梗阻性心肌病行左心室流出道疏通术与经皮室间隔化学消融术治疗的远期疗效分析 被引量:16

Long-Term Effects for Septal Myectomy Surgery and Percutaneous Transluminal Myocardial Septal Ablation in Patients With Hypertrophic Obstructive Cardiomyopathy
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摘要 目的:回顾性方法研究肥厚型梗阻性心肌病患者行左心室流出道疏通术与经皮室间隔化学消融术治疗的临床资料,评价两种治疗方法的远期疗效。方法:57例患者,28例行左心室流出道疏通术,29例行经皮室间隔化学消融术,分别比较两种方法治疗前、后左心室流出道压力阶差、室间隔厚度及每种方法治疗前后超声心动图结果,电话随访患者治疗后的临床症状。结果:28例左心室流出道疏通术患者平均年龄(36±16)岁,与术前比较,左心室流出道疏通术后室间隔厚度和左心室流出道压差明显下降,差异均有统计学意义(P<0.05);治疗后随访平均时间(3.8±1.2)年,并发症主要为心律失常,发生率64.3%,以完全左束支阻滞为主,胸闷好转率75%。经皮室间隔化学消融术患者平均年龄(43±11)岁,与术前比较,室间隔消融术后室间隔厚度和左心室流出道压差亦明显下降,差异均有统计学意义(P<0.05),治疗后随访平均时间(3.6±1.2)年,术后并发症主要为心律失常,发生率37.9%,以完全右束支阻滞为主,胸闷好转率75%。结论:外科左心室流出道疏通术及经皮室间隔化学消融治疗肥厚型梗阻性心肌病均可降低左心室流出道压力阶差,改善患者临床症状,有较好的远期疗效。 Objective:To compare the long-term outcomes of septal myectomy surgery and percutaneous transluminal myocardial septal ablation (PTMSA) in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods : A total of 57 HOCM patients including 28 of septal myectomy surgery ( Surgery group) and 29 of PTMSA ( PTMSA group) were recruited. We compared the representation of echocardiography in both groups before and after the procedure, and did telephone follow-up for patients' clinical symptoms after the procedure. Results:In surgery group, the patients' mean age was(36 ±16)years,left ventricular outflow tract gradient (LVOTG) before and after the surgery was 102. 3 ±45. 8 mmHg and 21.7 ± 17. 1 mmHg,interventricular septum thickness was 25.6 ±7.0 mm and 18. 3 ± 6.0 mm, left ventricular end-diastolic dimension was 39. 9± 5.9 mm and 41.7 ± 4.3 mm, respectively, P 〈 0. 05. The mean follow up time was (3.8 ± 1.2)years and the main complication was arrhythmia (64. 3% ). In PTSMA group, the patients' mean age was(43 ± 11 ) years,LVOTG before and after the procedure was 85.7 ±21.1 mmHg to 24. 6 ± 12. 2 mmHg,interventricular septum thickness was 22. 8 ±4. 0 mm to 18. 1 ±3.1 mm,left ventricular end-diastolic dimension was 43.6 ±5.3 to 46.7 ± 5.4 rnm,respectively,P 〈0. 05. The mean follow up time was (3.6 ±1.2) years and the main complication was arrhythmia (37.9%). Conclusion:Both Septal myectomy surgery and PTMSA could effectively decrease LVOTG and to improve patients' clinical condition. The long term outcome was similar for both procedures.
出处 《中国循环杂志》 CSCD 北大核心 2010年第1期38-40,共3页 Chinese Circulation Journal
关键词 肥厚型梗阻性心肌病 左心室流出道疏通术 经皮室间隔化学消融术 Hypertrophic obstructive cardiomyopathy Septal myectomy surgery, percutaneous transluminal myocardial septal ablation
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