Parylene涂层封堵器治疗儿童先天性心脏病疗效观察

发布时间：2018-02-21 18:17

本文关键词： 封堵器先天性心脏病介入治疗镍离子儿童　出处：《重庆医科大学学报》2014年10期 　论文类型：期刊论文

【摘要】：目的:探讨Parylene涂层封堵器(Parylene coating occluder)治疗儿童先天性心脏病(congenial heart diseases,CHD)的临床安全性、有效性及阻断镍离子释放入血的效果。方法:将待实施介入治疗的CHD患儿23例按照随机分组原则分为派瑞林组(A组)及传统组(B组),均为北京华医圣杰医疗器械公司产品。A组12例,其中室间隔缺损(ventricular septal defects,VSD)4例,动脉导管未闭(patent ductus arteriosus,PDA)8例,B组11例,其中VSD 3例,PPA 8例。所有患儿均由其监护人签署知情同意书。2组均在X线、心脏彩超及心电图监测下完成经导管介入封堵治疗,于术前,术后1 d、1月、3月、6月随访观察临床症状体征、肝肾功、血常规、心电图、心脏彩超、胸片及血镍浓度变化情况。结果:2组介入封堵治疗均成功,成功率均为100%(23/23);A组中有1例术后即刻有少量残余分流,随访至术后6月时残余分流消失。无机械性溶血、封堵器脱落、移位、心律失常等并发症发生。随访各时间点2组之间在临床症状体征、肝肾功能(分别为P=0.819、P=0.418、P=0.991、P=0.828)、血常规(分别为P=0.521、P=0.239、P=0.088)、心电图、心脏彩超(分别为P=0.249、P=0.239、P=0.213、P=0.071、P=0.397)、胸片(P分别为0.537、0.114)和血液镍离子浓度(P=0.797)方面均无统计学意义。结论:小儿CHD介入治疗中,Parylene涂层封堵器在有效性、安全性及阻断镍离子释放入血方面与传统封堵器无显著差异。
[Abstract]:Objective: to investigate the clinical safety of parylene coating occluder (Parylene) in the treatment of congenital heart disease in children. Methods: 23 children with CHD undergoing interventional therapy were randomly divided into group A (group A) and group B (group B). Group A, 12 cases, There were 4 cases of ventricular septal defect (VSD), 11 cases of patent ductus arteriosus (patent ductus arteriosus), 8 cases (group B) of ductus arteriosus, and 8 cases of VSD (n = 8). Transcatheter closure was performed by echocardiography and electrocardiogram monitoring. The clinical symptoms and signs, liver and kidney function, blood routine, electrocardiogram, echocardiography were followed up before, 1 day, January, March and June before and after operation. Results the success rate was 100% in group A and 1 case in group A had a little residual shunt immediately after operation, and the residual shunt disappeared immediately after follow-up until June. There was no mechanical hemolysis and the occluder fell off. The clinical symptoms and signs, liver and kidney function (P < 0. 819), liver and kidney function (P = 0. 9918), blood routine examination (P = 0. 521, P = 0. 239), electrocardiogram (ECG) were observed. There was no significant difference in color Doppler echocardiography (P < 0.249) and blood nickel ion concentration (P _ (0.797) and P _ (0.213) P _ (0.213) P _ (0.071)), P ~ (0.393) and P ~ (0.537) ~ (0.114), respectively. Conclusion: Parylene coated occluder is effective in interventional therapy of CHD in children. There was no significant difference between the safety and blocking of nickel ion release into blood compared with the traditional occluder.
【作者单位】：重庆医科大学附属儿童医院心内科儿童发育疾病研究教育部重点实验室儿科学重庆市实验室重庆市儿童发育重大疾病诊治与预防国际科技合作基地;
【基金】：重庆市卫生局资助(编号:2012-2-084)
【分类号】：R725.4

【参考文献】