介入封堵治疗对缺血性脑卒中合并卵圆孔未闭患者的临床疗效

目的 探讨介入封堵治疗在缺血性脑卒中合并卵圆孔未闭（PFO）患者治疗中的临床疗效.方法 选取2016年行卵圆孔封堵术6例,均经食管超声心动图（TEE）及经颅多普勒超声（TCD）增强发泡试验证实为PFO并存在右向左分流,其中合并脑梗塞5例,短暂性脑缺血1例,收集临床资料并对其进行随访.结果 所有患者均成功置入封堵器.术后心电监护1例出现阵发性房颤及1例偶发室性早搏.患者术后射血分数较术前升高（P〈0.05）,左室内径无明显差异.术后1d、1个月、3个月、6个月复查心超未见封堵器移位,房水平未见分流.结论 缺血性脑卒中患者行卵圆孔封堵术后再发缺血性脑血管事件概率降低,提示介入封堵治疗可能对于缺血性脑卒中合并PFO患者预防再发具有一定疗效.

Objective To investigate the clinical effects of transcatheter closure in ischemic stroke patients with patent foramen ovale. Methods 6 cases（5 Cerebral infarction and 1 transient ischemic attack） were chosen with the treatment of transcatheter closure in Shaoxing People＆#39;s hospital in 2016. PFO and right-to-left shunt were determined by the means of TEE and TCD. The clinical data and follow-up were collected. Results All patients were successful in closure. 1 case appeared paroxysmal atrial fibrillation and 1 case appeared ventricular premature beat occasionally after the treatment. The ejection fraction after the treatment was higher than before,and the difference was statistically significant（P〈0.05）. Echocardiography did not see plugging device shift and shunt in the first day,1,3,6 months after the treatment. Conclusion The reducing of recurrence of ischemic cerebrovascular event in ischemic stroke patients with patent foramen ovale means that transcatheter closure may have curative effect.