完全超声引导与放射线引导行经皮肺动脉瓣球囊成形术的对比研究

发布时间：2018-04-23 02:05

本文选题：肺动脉瓣狭窄 + 超声心动描记术　；参考：《中国循环杂志》2017年09期

【摘要】：目的:通过与传统放射线引导方法相比较,评价完全超声引导下经皮肺动脉瓣球囊成形术(PBPV)的安全性和有效性。方法:收集我院2013-03至2016-08完全超声引导下行PBPV患者102例(超声组),同期传统放射线引导下行PBPV患者280例(放射线组)。两组患者术后均以超声心动图进行随访和评价治疗效果。结果:两组患者年龄、体重、肺动脉瓣环直径、术前肺动脉瓣跨瓣压差、球囊直径、术后即刻跨瓣压差、住院时间及住院费用差异均无统计学意义(P均0.05)。超声组和放射线组手术成功率分别为99.0%和100%(P=0.267),超声组有1例患者因扩张后右心室流出道肌肉痉挛转为常规外科手术。放射线组术中操作时间(min)长于超声组(38.9±9.2比34.6±10.0,P0.001),放射线组放射线时间为(3.9±1.2)min。术后门诊平均随访(25.5±13.2)个月,超声组和放射线组肺动脉瓣跨瓣压差(mm Hg,1 mm Hg=0.133 k Pa)分别为(16.2±4.3比15.3±4.5,P=0.120),两组患者均无死亡、外周血管损伤、心脏穿孔、心包积液等严重并发症。结论:完全超声引导下PBPV不仅能够完全避免放射线及对比剂,而且保持了传统经皮介入治疗微创、安全及疗效确切的优点。
[Abstract]:Objective: to evaluate the safety and efficacy of percutaneous balloon pulmonary valvuloplasty (PBPVs) guided by complete ultrasound. Methods: 102 PBPV patients (ultrasound group) and 280 PBPV patients (conventional radiography-guided PBPV group) were collected from 2013-03 to 2016-08. The patients in both groups were followed up and evaluated by echocardiography after operation. Results: there were no significant differences in age, body weight, pulmonary annulus diameter, preoperative pulmonary valve pressure difference, balloon diameter, immediate transvalvular pressure difference, hospitalization time and hospitalization cost between the two groups (P < 0.05). The successful rate of operation in ultrasound group and radiation group was 99.0% and 100% respectively. One patient in ultrasound group was converted to conventional surgery because of spasm of right ventricular outflow tract after dilatation. The operative time of radiation group was 38.9 卤9.2 vs 34.6 卤10.0 P 0.001g, and that of radiation group was 3.9 卤1.2 min. The average follow-up period was 25.5 卤13.2 months. The pulmonary valve pressure difference of 1 mm Hg=0.133 k Pa1 mm in ultrasound group and radiation group was 16.2 卤4.3 vs 15.3 卤4.5 P0.120, respectively. There were no death, peripheral vascular injury, heart perforation, pericardial effusion and other serious complications in both groups. Conclusion: complete ultrasound guided PBPV can not only completely avoid radiation and contrast agents, but also maintain the advantages of minimally invasive, safe and effective percutaneous interventional therapy.
【作者单位】：中国医学科学院北京协和医学院国家心血管病中心阜外医院心血管外科;
【基金】：基金资助:首都临床特色应用研究(2016-BKJ03)
【分类号】：R541.1

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