130例介入封堵术治疗卵圆孔未闭患者的临床疗效和安全性

Clinical efficacy and safety of percutaneous closure of patent foramen ovale in 130 patients

目的:随访观察介入封堵术治疗卵圆孔未闭(PFO)的安全性和有效性,并探讨其临床意义。方法:选取2019年3月至2021年12月武汉大学中南医院心血管内科收治的130例PFO患者为研究对象,术前所有患者均经超声影像学证实为卵圆孔未闭并存在右向左分流。所有患者均行介入封堵术,术后随访观察半年,复查超声心动图、心电图等。结果:所有患者均成功置入封堵器,术后即刻超声心动图证实封堵器位置良好,未见房间分流,心脏瓣膜功能正常,术后并发症方面,1例患者出现咯血症状,出院后1周好转消失;2例患者出现股静脉穿刺部位皮下血肿,适当压迫、制动后逐渐吸收。随访半年,术前41例头痛患者,36例(87%)患者术后头痛有不同程度的缓解,术前32例头晕患者,21例(65%)患者术后头晕有所缓解。所有患者复查超声心动图封堵伞位置正常,均未见残余分流。未见其他并发症。结论:介入封堵术治疗卵圆孔未闭,安全、有效,可显著改善患者症状,值得推广,但远期疗效和并发症还值得观察研究。

Objective:To observe the safety and effectiveness of percutaneous closure in the treatment of patent foramen ovale(PFO),and to explore its clinical significance.Methods:From March 2019 to December 2021,130 patients with PFO were admitted to Zhongnan Hospital of Wuhan University as research objects.All patients were confirmed by ultrasound imaging as PFO and had a right-to-left shunt,and then received percutaneous closure and were followed up for half a year.Echocardiography and ECG results were assessed.Results:All patients were successfully implanted with occluder.Immediately after the operation,echocardiography confirmed that the occluder was in good position,no shunt was obtained,and the heart valve function was normal.In terms of postoperative complications,one patient had hemoptysis,and the sympom disappeared a week after discharge.Two patients had subcutaneous hematoma at the femoral vein puncture site,which was progressively absorbed after appropriate compression and immobilizing.After follow-up for half one year,of the 41 patients with headache before operation,36 patients(87%)with had different degrees of relief,and of the 32 patients with dizziness before operation,21 patients(65%)were relieved.All patients had normal occlusion umbrella position by echocardiography,and no residual shunt was discovered.No other complications were observed.Conclusion:Percutaneous closure is safe and effective in the treatment of patent foramen ovale,it can greatly relieve patients'symptoms and is worthy of application in clinic.Nevertheless,the long-term effectiveness and complications are still worthy of observation and research.