经胸超声心动图引导下行房间隔缺损封堵术治疗先天性房间隔缺损的临床研究

The Clinical Effects of Transthoracic Echocardiography guided Septal Defect Treatment on Congenital Atrial Septal Defect(ASD)

目的:探讨经胸超声心动图引导下行房间隔缺损封堵术治疗先天性房间隔缺损(Atrial septal defect,ASD)的临床疗效。方法:比较先天性ASD患者行超声心动图组(49例)或介入组(53例),患者的疗效及心脏功能的变化。结果:超声心动图组并发症发生率显著低于介入组(P<0.05);术后4周,两组患者的心率、舒张期室间隔厚度(Interventricular septal thickness,IVST)、左室后壁厚度(Left ventricular posterior wall thickness,LVPWT)、左心室心肌重量(Left ventricular mass,LVM)和左心室心肌重量指数(Left ventricular mass index,LVMI)明显降低(P<0.05),左心室射血分数(Left ventricular ejection fraction,LVEF)和左心室高峰充盈率(Left ventricular peak filling rate,LVPFR)均显著升高(P<0.05),其余指标则无明显变化(P>0.05);但术后1周超声心动图组的LVEF、IVST和LVMI即显著高于术前(P<0.05)。结论:胸超声心动图引导下行ASD封堵术与X线介入封堵术疗效相当,但前者可能对ASD患者的心脏功能的改善更为显著。

Objective： To explore the clinical effects of transthoracic echocardiography guided septal defect treatment on the congenital atrial septal defect（ASD）. Methods： The congenital ASD patients were collected and divided into transthoracic echocardiography group（49 cases） and intervention group（53 cases）. The clinical effects and cardiac function were compared between two groups. Results：The complication rate of transthoracic echocardiography group was significantly lower than that of the intervention group（P〈0.05）; At 4weeks time point after operation, the heart rate, interventricular septal thickness（IVST）, left ventricular posterior wall thickness（LVPWT）, left ventricular mass（LVM） and left ventricular mass index（LVMI） were all significantly decreased（P〈0.05）, while the left ventricular ejection fraction（LVEF） and left ventricular peak filling rate（LVPFR） were increased（P〈0.05）. There was no significant difference on the other indicators of cardiac function（P〉0.05）. However, at 1 week time point after operation, the levels of LVEF, IVST and LVMI were already significantly decreased（P〈0.05）. Conclusion： The curative efficacy of transthoracic echocardiography guided septal defect treatment on ASD is similar with X-gay guided ASD intervention surgery, but the improvements of former one on the cardiac function in patients with ASD may be much better.