摘要
目的 评价经皮肺动脉瓣球囊成形术 (PBPV)治疗单纯肺动脉瓣狭窄 (PS)的中远期疗效。方法 自 1986年 3月至 2 0 0 1年 10月PBPV治疗PS 36 9例。年龄 11个月～ 5 0岁 ,平均 (10 7±9 7)岁。术前平均肺动脉 右心室收缩压差 (PPG) (89 6± 39 3)mmHg (1mmHg=0 133kPa)。 36 9例患者中、重度狭窄 311例 ,占 84 3%。使用双、单和Inoue球囊分别为 13、2 35及 12 1例。 2 2 0例心电图(ECG)示右心室肥厚。 14 9例 (40 4 % )术后平均 (2 4 8± 2 6 5 )个月经右心导管或 /和ECG、超声心动图 (Echo)、X线胸片随诊。结果 36 9例术后即刻PPG降至 10～ 14 0 (2 0 9± 2 3 9)mmHg,而跨瓣收缩压差仅 0～ 5 1(10 9± 7 7)mmHg。疗效总优良率 99 7% ,无重要并发症。 14 9例随诊中PPG进一步降低 ,85例ECG右心室肥厚术后转为正常 ,无一例发生再狭窄。结论 PBPV疗效优良 ,应为PS首选治疗方法 ,其中远期效果好。
Objective To evaluate the immediate and mid-long term results of percutaneous balloon pulmonary valvuloplasty (PBPV) in treating patients with pulmonary valve stenosis(PS). Methods Since March 1986 to October 2001, 369 patients with isolated PS have been treated. The age was ranged from 11 months to 50 years (mean 10.7±9.7 years). The peak systolic pressure gradient across pulmonary artery and right ventricle(PPG) were from 26-241 mm Hg(mean 89.6±39.3) before PBPV. Among them, 311patients (84.3%) with PS were of moderate to severe degree. Double-balloon technique was used in 13, single-balloon in 235, and Inoue-balloon in 121 patients. In 220 patients, right ventricle hypertrophy were showed in ECG. Follow-up study was carried out in 149 cases by catheterization, ECG, Echocadiography and/or chest film in 3-132 months after PBPV. Results In 369 patients, the mean PPG were dropped to 20.9±23.9 mm Hg after PBPV immediately. The PTG was decreased to be 10.9±7.67 mm Hg. Excellent to good result of PBPV was obtained in 368 cases (99.7%) without major complications. The immediately result of PBPV using Inoue-balloon technique was better than the other two ones. In 149 patients with mid-long term follow up study, the PPG were decreased further. In 85 patients, right ventricle hypertrophy shown in ECG was disappeared in follow up examination. Conclusion PBPV is the first choice for treating isolated PS with excellent to good results. To choose the appropriate size of balloon catherter is the key for success of PBPV procedure with less complication.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2003年第5期323-325,共3页
Chinese Journal of Cardiology
