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|本期目录/Table of Contents|

多中心应用两种超声心动图指导房间隔缺损封堵治疗情况的比较(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2008年第2期
页码:
158-161
栏目:
临床研究
出版日期:
2008-03-20

文章信息/Info

Title:
A multicentre study: Trancatheter closure of secundum atrial septal defect guided by transthoracic echocardiography
作者:
张玉顺1; 2; 马业新1; 肖建民1; 马东江2;  李寰1; 张军3 ; 李军3
1.华中科技大学同济医学院附属同济医院心内科，湖北 武汉 430030；2.西安交通大学医学院
Author(s):
ZHANG Yushun1;  MA Yexin1;  Xiao Jianmin1;  MA Dongjiang2; LI Huan1;  ZHANG Jun3;  LI Jun3
1.Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; 2.Second Department of Cardiology, First Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China; 3.Department of Ultrasonic diagnosis, Xijing Hospital, Fourth Military Medical University , Xi'an 710032, Shaanxi, China
关键词:
房间隔缺损; 介入治疗; 封堵
Keywords:
Atrial septal defects;  Interventional therapy;  Transcatheter closure
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的 评价经胸超声心动图指导房间隔缺损（ASD）封堵治疗的效果。方法 总结18个医院ASD封堵治疗患者2 108例，按经食管超声心动图(TEE)和经胸超声心动图(TTE)检查和指导封堵治疗的不同，分为TEE组和TTE组。其中TEE组504（男197，女307)例，年龄12～65（28±15）岁；TTE组1 604（男621，女983）例，年龄1～70（23±11）岁。结果 TEE组和TTE组ASD最大直径为（22±10）mm vs （21±11）mm，所植入封堵器的大小为（26±8）mm vs （27±9）mm ，手术技术成功率95.4％ vs 95.9％，微少量残余分流率即刻为13％ vs 12％，随访3～6月为2.8％ vs 2.9％，两组相比均无统计学差异。但手术操作时间TTE组明显短于TEE组（P<0.01）。TEE组和TTE组发生心包填塞均为0.6％，发生脑出血或脑梗死为0.2％ vs 0.1％，短暂房室传导阻滞为2.6％ vs 1.7％，术后发生阵发性房颤为1.2％ vs 1.7％，两组相比均无显著统计学差异。结论 两种超声心动图指导ASD封堵术均成功率高，安全性好，无显著差异。但TTE较TEE指导ASD封堵治疗操作更为简便，可显著缩短手术时间。
Abstract:
AIM To evaluate the efficiency of trancatheter closure of secundum atrial septal defect (ASD) guided by transesophageal echocardiography (TEE) or transthoracic echocardiography (TTE). METHODS We analyzed the outcome of 2 108 patients who underwent percutaneous transcatheter closure of ASD with atrial septal occluder (ASO) from the centre of cardiovascular disease in 18 hospitals. According to the guidance type in closure procedures, the patients were divided into two groups, TEE or TTE. Five hundred and four patients were enrolled in TEE group ［197 male and 307 female, mean age (28±15) years］ and 1 604 patients in TTE group ［621 male and 983 female, mean age (23±11)years］. RESULTS No significant difference was found between the two groups in the largest ASD diameter ［(22±10)mm vs (21±11)mm］, the size of implanted ASO ［(26±8)mm vs (27±9)mm］, the rates of complete closure of ASD and trivial to small residual shunting immediately or during the 36 month followup. But the procedural time of closure procedures was significantly shorter in TTE than that in TEE (P<0.01). No significant difference was seen between the two groups in complications related to the procedure, including pericardial tamponade (0.6% vs 0.6%), stroke (0.2% vs 0.1%), transient atrial ventricular block (2.6% vs 1.7%) and paroxysm atrial fibrillation (1.2% vs 1.7%). CONCLUSION Guidance with TEE or TTE is sage and of a high success rate, with no significant difference. But compared with guidance by TEE, transcatheter closure of ASD under TTE is easier for operation and effective shortening of operation time.

参考文献/References

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［2］ Berger F, Ewert P, Abdulkhaliq H, et al . Percutaneous closure of large atrial septal defects with the Amplatzer Septal Occluder: technical overkill or recommendable treatment［J］. J Interv Cardiol,2001,14(1):63-67.

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［7］ Godart F, Rey C , Francart C, et al. Twodimensional echocardiographic and color Doppler measurements of atrial septal defect,and comparison with the balloonstretched diameter［J］. Am J Cardiol, 1993,72(14 ):1095-1097.

［8］ Divekar A, Gaamangwe T, Shaikh N, et al. Cardiac perforation after device closure of atriai septal defects with the Amplatzer septal occluder［J］. J Am Coll Cardiol, 2005,45 (8 ):1213-1218.

［9］ Chun DS, Turrentine MW, Moustapha A, et al. Development of aortaright atrial fistula following closure of secundum atrial septal defect using the Amplatzer septal occluder［J］. Catheter Cardiovasc Interv, 2003,58(2):246-251.

［10］徐立,戴汝平,刘延玲,等. Amplatzer法房间隔缺损封堵术经食道超声心动图测量选择封堵器的可行性［J］. 中华心血管病杂志,2001,29 (5):297-299.

［11］张玉顺,代政学,贾国良,等. 根据食道超声心动图测量值选择封堵器介入治疗房间隔缺损Amplatzer封堵法改良Ⅰ［J］. 第四军医大学学报,2001,22 (21):1921-1923.

备注/Memo

备注/Memo:
收稿日期：2008-01-09.作者简介：张玉顺，主任医师，博士生Email：zys2889@sina.com
更新日期/Last Update: