先天性心脏病第2次手术前心导管检查和临床评估

Catherization in congenital heart diseased patients with stage operation

目的 探讨先天性心脏病(先心病)手术后心导管检查的适应证及临床评价。方法 选取1999年4月～2002年12月先心病术后患儿在心内科行心导管术65例,占同期先心病心导管术总数的2.2％,入院后常规行心电图、X线胸片及超声心动图检查,结合原手术方案选择相应的心腔、血管造影,检测相关部位的压力、血氧饱和度。结果 65例心导管术无一例出现严重并发症,综合心导管资料及其他辅助检查,需再次外科手术39例,暂不需手术而进一步随访观察9例,在心导管术中行介入治疗9例,4例需放置支架,无再次外科手术指征4例。结论 心导管术不仅能提供精确的病理生理参数,而且可提供详尽的解剖资料,对一些复杂的先心病,特别是外科手术后的先心病具有重要的临床价值。

Objective To explore the indications and clinical assessment for catherization in congenital heart diseased patients with stage operation. Methods Sixty five patients were selected from Apr. 1999 to Dec. 2002 undergoing second catherization. 47 male, 18 females with age ranging from 5 months to 22 years old on average of 6.8 years. EKG, chest X-ray, ECHO, cardiovascular pressure and blood oxygen saturation were taken in all patients during the procedure. Results According to the physiologic data recorded during the procedure of catherization, 39 cases needed one more surgery, 9 cases for intervention, 4 cases would be placed with endovascular stent 9 cases should be follow-up and 4 cases couldn t be operated again. Conclusions Catherization is not only offering the accurate physiologic data, but also revealing the details about anatomy with important information to the diagnosis and treatment for the congenital heart disease, especially for the srage-operation.