经皮介入治疗常见先天性心脏病500例临床疗效和安全性分析

The clinical efficacy and safety analysis of 500 cases with common congenital heart disease undergoing percutaneous interventional treatment

目的 回顾性分析500例使用Amplazter封堵器介入治疗先天性心脏病的临床疗效和安全性.方法 回顾性分析我院2003年1月至2015年5月500例先天性心脏病患者的临床资料,男性208例,女性292例,年龄2-65岁,平均15.5岁;室间隔缺损88例,房间隔缺损300例,动脉导管未闭106例,肺动脉瓣狭窄6例,其中室间隔缺损合并房间隔缺损3例、房间隔缺损合并动脉导管未闭3例、室间隔缺损合并动脉导管未闭2例.所有患者均经临床心电图、经胸超声心动图进行术前筛选,术中监测和术后随访.所有患者均采用国产封堵器及输送系统.结果 总成功率96.8％,室间隔缺损4例失败,房间隔缺损8例失败,动脉导管未闭4例失败.住院时间3-7 d.全组介入治疗患者门诊行心彩超、心电图、胸部X片随访l-3年,均无并发症发生.结论 只要严格掌握手术适应证,经皮导管介入治疗先天性心脏病操作简单、创伤小、安全、可靠、成功率高、并发症低、恢复快、疗效确切,对部分患者可替代外科手术.同时国产封堵器价格低、封堵效果好.

Objective To evaluate the clinical curative effect and safety of interventional treatment by using Amplazter closure for congenital heart disease. Methods The data of 500 patients with congenital heart dis- ease admitted in our hospital from January 2003-May 2015 were retrospective analyzed, including 208 cases of male, female 292 eases and aged 2-65 years old （average 15.5 years）. Ventrieular septal defect in 88 cases, 300 cases of atrial septal defects, artery catheter did not closed in 106 cases, 6 cases of pulmonary stenosis. The merger （3 cases）, atrial septal defects VSD combined arterial catheter atrial septal defects not 3 cases of closed, ventricular septal defect combined arterial catheter was not closed in 2 eases. All patients were approved by clinical electrocardiogram, the thoracic echocardiography for preoperative screening, intraoperative monitoring and postoper- ative follow-up, all patients were using home-made occluder and transportation system. Results Total success rate 96.8%, ventricular septal defect, 4 cases of failure in 8 cases of atrial septal defects failure, arterial catheter was not closed 4 cases failed, length of hospital stay 3 to 7 days, the whole group of patients with interventional therapy outpatient service line heart eolour to exceed, electrocardiogram, chest X-ray were followed up for 1-3 years, no complications occurred. Conclusion As long as master the operation indications strictly, percutaneous interventional treatment of congenital heart disease operation is simple, small trauma, safe, reliable, high success rate, low complication, fast recovery, curative effect, some alternative surgical patients, home-made occluder low price at the same time, the sealing effect is good.