先天性心脏病介入治疗17例并发症的原因及处理

Incidence and treatment of complications in interventional therapy for congenital heart diseases

目的分析先天性心脏病(先心病)介入封堵治疗中和治疗后并发症的发生率、原因及防治措施。方法自2008年3月至2012年3月,上海远大心胸医院共有1077例先心病患者进行了介入治疗,对介入治疗中和治疗后发生的17例并发症患者作回顾性分析。结果 1077例先心病患者介入术中及术后并发症总发生率为1.58%(17/1077),无死亡病例。房间隔缺损(ASD)组共3例出现并发症,占了ASD组的0.99%(3/303);动脉导管未闭(PDA)组共3例出现并发症占了PDA组的0.97%(3/310);室间隔缺损组(VSD)组共11例出现并发症,占了VSD组的2.61%(11/421),肺动脉瓣球囊成形术(PBPV)组未见并发症,并发症均经保守治疗或介入处理。结论先心病介入封堵术是一种微创而有效的治疗措施,但其并发症不容忽视,尤以VSD封堵术发生率最高。先心病介入治疗的并发症及病死率低,术前应进行充分沟通,术后应作严格随访,尤其警惕部分介入治疗术后迟发并发症的发生。

Objective To analyze the incidence, causes and treatment of severe complications in interventional therapy for congenital heart disease （CHD）. Methods From March 2008 to March 2012, 17 out of 1077 patients with CHD admitted into Shanghai Yodak Cardiothoracic Hospital developed complications during and post interventional therapy. Clinical data of these 17 patients were retrospectively analyzed. Results The overall complication rate was 1.58% （17/1077）, 0. 97% （3/310） for patent ductus arteriosus （ PDA ）, 0. 99% （ 3/303 ） for atrial septal defect （ ASD ） and 2. 61% （ 11/421 ） for ventricular septal defect（VSD）. No complications for percutaneous balloon pulmonary valvuloplasty （PBPV） ~ Conclusions Though interventional therapies are minor-invasive and efficient for patients with CHD, their complications, especially in VSD, cannot be ignored. The omplications and mortality rate of interventional therapy for CHD are relative low. Post procedure follow-up is needed fro monitoring possible procedure- related complications.