单纯超声引导下经皮肺动脉瓣球囊扩张术治疗肺动脉瓣狭窄的疗效分析

Clinical efficacy analysis of percutaneous balloon pulmonary valvuloplasty for pulmonary valve stenosis guided by ultrasound

目的分析超声引导下经皮肺动脉瓣球囊扩张术的有效性和安全性。方法2016年3月至2019年7月我院收治肺动脉瓣狭窄患者32例,其中男19例、女13例,年龄1~12(6.2±3.1)岁,体重7~45(22.7±9.2)kg。术中应用经胸超声心动图(TTE),多切面全程引导下经股静脉行肺动脉瓣球囊扩张术,评价其疗效。结果术前超声评估患者肺动脉瓣跨瓣压差(PG)为(65.4±11.9)mm Hg。全组患者均在超声引导下成功完成扩张术,术后即刻PG(19.7±4.0)mm Hg,较术前显著下降(P<0.001)。所有患者均存活,未见严重并发症。术后3个月、6个月、12个月随访PG分别为(18.4±4.0)mm Hg、(16.4±3.9)mm Hg、(15.2±3.3)mm Hg,显著低于术前水平(P<0.001)。结论超声心动图引导下经股静脉肺动脉瓣球囊扩张术治疗肺动脉瓣狭窄安全有效,其总体疗效满意,并发症发生率低。

Objective To analyze the efficacy and safety of percutaneous balloon pulmonary valvuloplasty(PBPV)for pulmonary valve stenosis guided by ultrasound.Methods From March 2016 to July 2019,32 patients with pulmonary valve stenosis were treated in our hospital.There were 19 males and 13 females with an average age of 1-12(6.2±3.1)years and weight of 7-45(22.7±9.2)kg.The clinical efficacy of PBPV guided by transthoracic echocardiography(TTE)was evaluated.Results The transvalvular pressure gradient(PG)of the patients before PBPV was 65.4±11.9 mm Hg.All patients successfully received PBPV under TTE guidance.The PG was 19.7±4.0 mm Hg immediately after operation,which was significantly decreased(P<0.001).All patients survived without any serious complications.The PG values at 3 months,6 months and 12 months after operation were 18.4±4.0 mm Hg,16.4±3.9 mm Hg,15.2±3.3 mm Hg,respectively,which were significantly lower than that before the operation(P<0.001).Conclusion PBPV guided by echocardiography is safe and effective in the treatment of pulmonary valve stenosis with low complications rate.