摘要
目的探讨经皮球囊肺动脉瓣成形术(PBPV)治疗婴幼儿重度肺动脉瓣狭窄(PVS)的效果和安全性。方法自2001年9月至2010年6月,共对44例2～35个月的重度PVS患儿进行PBPV治疗,并按年龄分为婴儿组(<12个月,n=18)、幼儿一组(12～23个月,n=13)、幼儿二组(24～35个月,n=13)比较不同年龄组患儿PBPV的治疗效果和并发症。结果所有患儿均成功实施PBPV,术后右心室压力和跨肺动脉瓣压力阶差显著下降,无死亡和严重并发症发生。术后出现肺动脉瓣关闭不全13例(29.5%),三尖瓣关闭不全5例(11.4%)。婴儿组术前右心室收缩后和术后右心室收缩后、术后肺动脉收缩压、术后跨肺动脉瓣压力阶差与幼儿一组、二组比较差别无统计学意义(P均>0.05)。随访显示,患儿跨肺动脉瓣压力阶差基本保持稳定,仅1例患儿再次升高。结论 PBPV治疗重度婴幼儿PVS安全可靠,能有效解除肺动脉瓣狭窄。与幼儿一组、二组比较,婴儿PBPV在疗效和安全性方面差别无统计学意义。
Objective To evaluate the effect and safety of percutaneous balloon pulmonary valvuloplasty（PBPV）in infants and toddlers with severe congenital pulmonary valve stenosis（PVS）.Methods From September 2001 to June 2010,44 patients less than 36 months old with severe PVS underwent PBPV.The patients were divided into infant group（n = 18）,toddler group 1（n = 13）,toddler group 2（n = 13）.The treatment outcomes and compli-cations were compared between three groups.Results All patients underwent PBPV successfully.After PBPV,both of right ventricular peak systolic pressure（RVSP）and systolic trans-pulmonary pressure gradient（TPG）were significantly decreased.There were no serious complications and death during PBPV.Thirteen（29.5%）patients had pulmonary regurgitation and 5（11.4%） patients had tricuspid regurgitation.Compared with toddlers,RVSP,pulmonary artery systolic pressure,and TPG after PBPV were similar in infants（all P 0.05）.Long term follow-up revealed that,TPG remained stable with only one patient having TPG increased again.Conclusion BPPV as a treatment of PVS in infant and toddler＇s PVS is safe and reliable.It can effectively relieve pulmonary stenosis.There are no difference in efficacy and safety between infants and toddlers.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2011年第7期617-620,共4页
Journal of Clinical Pediatrics
关键词
肺动脉瓣狭窄
瓣膜成形术
婴儿
幼儿
pulmonary valve stenosis
balloon valvuloplasty
infant
toddler
