贵州医科大学学报

2015, v.40;No.182(11) 1239-1241

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扁平指数在继发孔型房间隔缺损介入封堵术中的应用
Application of Flat Index in Transcatheter Closure of Secundum Atrial Septal Defect

王青雷;刘晓桥;张长海;梁勤;
WANG Qinglei;Liu xiaoqiao;ZHANG Changhai;LIANG Qin;Department of Cardiology,Affiliated Hospital of Jining Medical College;Department of Cardiology,People's Hospital of Guizhou Province;

摘要(Abstract):

目的:探讨扁平指数在继发孔型房间隔缺损(ASD)介入封堵术中的应用效果。方法:76例继发孔型ASD患者分为A组(扁率>0.2,n=36)和B组(扁率<0.2,n=40),A组用经胸超声心动图(TTE)测量ASD最大直径并用扁平指数校正,选择封堵器;B组在超声测量ASD的最大直径值基础上增加4~6 mm选择封堵器;比较2组患者封堵器的封堵器直径及封堵器释放后腰部直径,治疗术后心脏超声、残余分流、封堵器移位及其对周围结构的不良影响。结果:A组TTE测量最大直径与B组比较,差异无统计学意义(P>0.05);A组选择的封堵器直径小于B组,差异有统计学意义(P<0.05),两组全部病例均封堵成功,无主要手术相关并发症发生;随访3~12月患者均无残余分流、封堵器脱落、移位及心律失常,对周围结构无不良影响。结论:根据扁平指数选择封堵器在继发孔型房间隔缺损介入封堵术中的效果良好。
Objective: To explore the curative effect of flat index in transcatheter closure of secundum atrial septal defect( ASD). Methods: Seventy-six patients with secundum ASD were divided into group A( oblateness > 0. 2,n = 36) and group B( oblateness < 0. 2,n = 40). ASD maximun diameter of patients in group A was detected with transthoracic echocardiography( TTE) and corrected by flat index,and occluder was chosen based on the results. Patients in group B were given occluder of which the diameter value increased 4 ~ 6 mm on the basis of ASD maximun diameter. The occluder diameter,TTE changes,residual shunt incidence,occluder displacement conditions and bad influence of occluder to heart surrounding structure were compared between the two groups. Results: There was no significant difference in ASD maximun diameter between the two groups( P > 0. 05). The occluder diameter of group A was significantly smaller than that in group B( P < 0. 05). The surgery was successful and no severe operation complications happened in the two groups. Residual shunt,occluder displacement,bad influenes of occluder to heart surrounding structure were not found during the 6 months' follow up period.Conclusions: Flat index is reasonable in occluder selection in the treatment of secundum ASD.

关键词(KeyWords): 房间隔缺损,继发孔型;扁率;扁平指数;封堵器;经胸超声心动图
atrial septal defect,secundum;oblateness;flat index;occluder;transthoracic echocar-diography

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基金项目(Foundation): 贵州省科技厅攻关项目[黔科合SY字(2011)3206号]

作者(Author): 王青雷;刘晓桥;张长海;梁勤;
WANG Qinglei;Liu xiaoqiao;ZHANG Changhai;LIANG Qin;Department of Cardiology,Affiliated Hospital of Jining Medical College;Department of Cardiology,People's Hospital of Guizhou Province;

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