我国先天性心脏病介入治疗现状初步分析

Current Status of Interventions for Congenital Heart Disease in China-Preliminary Analysis

目的 分析我国先天性心脏病介入治疗现状。方法 病例来源于国内七所大的医学中心 1980s年至2 0 0 1年 5月的初步统计 ,共完成 43 97例十余种先心病的介入性治疗 ,其中包括肺动脉瓣狭窄 173 9例 ,动脉导管未闭14 80 ,房间隔缺损 790例 ,主动脉缩窄 47例 ,体 -肺侧枝循环栓塞 46例 ,肺动 -静脉瘘 40例 ,主动脉瓣狭窄 40例 ,冠状动脉瘘 3 3例 ,室间隔缺损 12例 ,房间隔造口术 80例 ,其它 40例。介入治疗方法包括①瓣膜球囊扩张术 -治疗肺动脉瓣、主动脉狭窄。②经皮穿刺血管成形术 -治疗主动脉缩窄、肺动脉狭窄。③封堵术 -治疗动脉导管未闭、房间隔缺损、室间隔缺损。④栓塞术 -治疗肺动 -静脉瘘、冠状动脉瘘。⑤治疗性造口术 -房间隔缺口术等。结论 全组介入治疗技术成功率为 98.1% ,重要并发症为 1.9% (80 /4 3 97) ,死亡率为 0 .0 9% (4 /4 3 97)。死亡率 :0 .0 9% (4 /4 3 97)。讨论 我国每年有 15万患有各种类型先心病新生儿出生 ,根据七家医学中心的经验 ,介入治疗是非手术、有效的治疗方法 ,并发症、死亡率低 ,治疗先心病值得推广。 2 1世纪会有更好的发展 ,更多病人受益。

Objective:To analyze the current status of interventionas for of congenital heart disease in China.Material and methods:According to seven lager cardiac centers date, 4397 patents with various congenital heart disease were treated by interventional procedure during the period from 1980s to May 2001. The patient distribution included pulmonary stenosis 1739, patent ductus arteriosus 1480 atrial septal defect 790, ventricular septal defect 12, aortic coarctation 47, pulmonary A-V fistula 40, coronary artery fistula 33, systemic-pulmonary collateral vessels 46, aortic stenosis 40, atrial septostomy 80 and, others 40 cases. Internventional procedues included: balloon valvuloplasty, balloon angioplasty, occlusion, embolization and theraputic septostomy.Results:Among the 4397 patients , the technical successful rate was 98.1% (4393/4397), complication rate 1.9% (80/4397), mortality 0.09% (4/4397). Conclusion:0.15 million newborn with congenital heart disease were born in China every year. According to the experience of the seven medical centers , interventional procedure is a nonsurgical, effective and safe method for treating congenital heart disease with minimal morbidity or mortality. In 21 century, Interventional therapy for congenital heart disease will become better developed. More patients will benefit from this new and effective treatment. There is still much work to be done in this field of pediatric interventional cardiology such as ①a law about the interventional medicine should be established and enforced; ②training more young specialists; ③improving interventional equipment in catheterirazation laboratory; ④developing homemade interventional devices and technique.