摘要
目的 评价多种介入治疗技术 (主要包括血管栓塞术、房间隔造口术、瓣膜或血管内球囊成形术等 )与外科手术联合治疗某些复杂先天性心脏病的效果及其临床应用价值。方法 1990年9月至 2 0 0 3年 3月 ,我院共有 2 4例复杂先天性心脏病患者除接受外科矫治外还接受了介入治疗 ,其中有 15例采用体肺侧支栓塞术 (栓塞组 ) ,5例采用房间隔造口术 (造口组 ) ,4例采用瓣膜或血管内成形术 (球囊成形组 )。介入治疗大多数在外科手术前进行 ,少数在外科手术后择期进行。结果 所有介入治疗均获成功 ,技术成功率 10 0 % ,无严重并发症发生。其中栓塞组 :共对肺动脉闭锁或重症Fallot四联症患儿的 33支侧支血管进行了选择性栓塞治疗 (13例于外科手术前、2例于术后 ) ,完全栓塞率 82 %。栓塞术后的外科矫治术均获成功 ,除 2例术后监护中死于呼吸循环衰竭外 ,其余均恢复。造口组 :5例完全性大动脉转位的患儿经造口术后 ,股动脉血氧饱和度由 76 2 %上升到 87 5 % ,缺氧状态得到不同程度缓解 ,均于即刻或择期成功行外科矫治术 ,术后顺利出院。球囊成形组 :2例重度肺动脉瓣狭窄患儿 (Fallot三联症 )因缺氧发作 ,急诊行瓣膜球囊扩张术后择期行外科矫治术成功 ;1例主动脉缩窄合并单心室、1例主动脉缩窄合并室间隔缺损及永存?
Objective To evaluate the efficacy of various interventional technique combined with surgical treatment for complex congenital heart disease. Methods From September 1990 to March 2003 ,twenty-four(14 males,10 females, ages from 5 days to 16 years) patients with complex congenital heart disease underwent an attempt of interventional therapy before (or after) surgical treatment, including three groups: group I (15 patients),occlusion of systemic-pulmonary collaterals using coils; group Ⅱ(5 patients), septotomy by balloon catheter; group Ⅲ(4 patients), valvuloplasty or angioplasty. Results All intervention therapies achieved successfully without severe complications;in sixteen patients surgery was performed immediately after interventional procedure, in six patients a selective surgery was performed, in two patients remediable interventional therapy was performed after surgical treatments. All surgery achieved successfully too, no patients died during operations, excluding two patients died several days later due to complications of respiratory system. Twenty-two patients discharged with cure. Conclusion Applications of interventional technique could improve the clinical status of patients in emergency and pull off the time of operations; it may simplify the surgical procedure, reduce the difficulty of operation and deal with the complications associated with surgery. Interventional technique combined surgery will be used more frequently in complex congenital heart disease.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2004年第2期144-147,共4页
Chinese Journal of Cardiology
