卵圆孔未闭封堵术在少量右向左分流患者中的临床疗效评价

Clinical Evaluation of Patent Foramen Ovale Closure in Slight Right-to-left Shunt Patients

目的 探讨伴有少量右向左分流(RLS)的卵圆孔未闭(PFO)行经导管封堵术的临床疗效、安全性及预后。方法 本研究选取2015年7月—2017年12月衡水市人民医院心外科行PFO封堵术的患者共30例,其中伴有少量RLS者11例(A1组),伴有中到大量RLS者19例(A2组);选取同期行药物治疗的PFO患者30例为对照组(B组)。对比分析了各组卒中复发率、手术组的手术成功率及预后等指标。结果 经导管封堵少量RLS组与中到大量RLS组术后均无残余分流,手术成功率84.6%,与药物治疗相比,少量RLS组行PFO封堵术可取得与伴有中到大量RLS组同样的临床疗效,均可降低卒中复发率。结论 伴有少量RLS的PFO患者亦可考虑行PFO封堵术,但该结果需进一步的前瞻性研究证实。

Objective To investigate the clinical efficacy, safety and prognosis of transcatheter patent foramen ovale (PFO) closure for a slight right-to-left shunt (RLS). Methods A total of 30 patients who underwent PFO occlusion from July 2015 to December 2017 in Hengshui People’s Hospital were selected, including 11 patients with a small amount of RLS (A1 group) and 19 patients with moderate to large RLS (A2 group). 30 patients with PFO who were treated with drugs at the same time were selected as control group (group B). The recurrence rate of stroke, the success rate of operation and prognosis in each group were compared and analyzed. Results There was no residual shunt in transcatheter closure of small amount of RLS group and medium and large amount of RLS group, and the success rate of operation was 84.6%. Compared with drug therapy, PFO occlusion in a small amount of RLS group could achieve the same clinical effect as that of medium and large amount of RLS group, and significantly reduce the recurrence rate of stroke. Conclusion PFO occlusion should also be considered for PFO patients with a small amount of RLS. However, further prospective studies are needed.