食管超声心动图引导技术在房、室间隔缺损介入封堵术中的应用研究
发布时间：2019-05-29 10:46
【摘要】：目的研究食管超声心动图引导技术(TEE)在房间隔缺损(ASD)和室间隔缺损(VSD)介入封堵术中的应用价值,探讨该技术的可行性材料与方法回顾性分析郑州大学人民医院(河南省人民医院)2013年11月至2016年2月在食管超声心动图引导下行房、室间隔缺损介入封堵术患者的临床资料,总结食管超声心动图引导下行房、室间隔缺损介入封堵术的操作技巧与要点。研究:1.食管超声心动图引导下经股静脉途径行房间隔缺损介入封堵术的可行性;2.食管超声心动图引导下经颈内静脉途径行房间隔缺损介入封堵术的可行性;3.食管超声心动图引导下经股动脉途径逆行插管行室间隔缺损介入封堵术的可行性;与同期连续放射线下行常规房、室间隔缺损介入封堵术患者分别从手术时间、成功率、应用放射线和对比剂多少、并发症、卧床时间、住院时间及术后短期随访结果等进行对比研究,以确定食管超声心动图引导技术行房、室间隔缺损介入封堵术在临床中的应用价值。1.食管超声心动图引导下经股静脉途径行房间隔缺损介入封堵术21例患者全部成功,术中未应用放射线,与同期连续73例放射线下常规房间隔缺损介入封堵术患者比较,在成功率、手术操作时间、住院时间、及术后并发症方面无统计学差异(p0.05)。2.食管超声心动图引导下经颈内静脉途径行房间隔缺损介入封堵术25例,24例成功,1例双孔型房间隔缺损患儿,封堵大孔后,小孔未完全覆盖残余5mm过隔血流,术中转为外科侧开胸修补手术成功。25例患者术中均未应用放射线,与连续73例放射线下常规房间隔缺损介入封堵术患者相比,基本资料、住院时间均无统计学差异(p0.05),但在手术操作时间及卧床时间较对照组明显缩短,且差异有统计学意义(p㩳0.05)。3.食管超声心动图引导下经股动脉逆行插管行室间隔缺损介入封堵术患者14例,手术全部成功,均未应用放射线和造影剂,与同期连续15例放射线下常规室间隔缺损介入封堵患者比较,在成功率、手术操作时间、住院时间、术后并发症等方面均无明显差异(p0.05)。短期内随访结果良好。结果结论1.食管超声心动图引导下行房、室间隔缺损介入封堵术具有可行性,既保留了常规介入封堵术的微创、安全的优点,又避免了放射线和对比剂的损害,随着现有器材的改进有进一步的应用前景。2.食管超声心动图引导下经颈内静脉途径行房间隔缺损介入封堵术安全可行,较对照组相比手术操作时间及卧床时间明显缩短。3.食管超声心动图引导下行室间隔缺损介入封堵术安全可行,较对照组相比进一步简化了手术步骤。
[Abstract]:Objective to study the value of esophageal echocardiography guided (TEE) in interventional closure of atrial septum defect (ASD) and ventricular septum defect (VSD). To explore the feasible materials and methods the clinical data of patients undergoing transcatheter closure of ventricular septum defect under the guidance of esophageal echocardiography in Zhengzhou University people's Hospital (Henan Provincial people's Hospital) from November 2013 to February 2016 were analyzed retrospectively. the clinical data of patients undergoing transcatheter closure of ventricular septum defect under the guidance of esophageal echocardiography were analyzed retrospectively. To summarize the skills and key points of transcatheter closure of atrial and ventricular septum defects under the guidance of esophageal echocardiography. Research: 1. The feasibility of transcatheter closure of atrial septum defect under the guidance of esophageal echocardiography; 2. The feasibility of interventional closure of atrial septum defect through internal jugular vein under the guidance of esophageal echocardiography; 3. The feasibility of transcatheter closure of ventricular septum defect by retrograde catheterization through femoral artery under the guidance of esophageal echocardiography. Patients with conventional atrium and ventricular septum defect were treated with continuous radiation at the same time from operation time, success rate, how much radiation and contrast agent were used, complications, bed rest time, The duration of hospitalization and the results of short-term follow-up after operation were compared to determine the clinical value of transcatheter closure of ventricular septum defect guided by esophageal echocardiography. All 21 patients were successfully treated with transcatheter closure of atrial septum defect under the guidance of esophageal echocardiography, and no radiation was used during the operation, compared with 73 consecutive patients with conventional closure of atrial septum defect under radiation at the same time. There was no significant difference in success rate, operation time, hospitalization time and postoperative complications (p0.05). Interventional closure of atrial septum defect was performed through internal jugular vein in 25 cases under the guidance of esophageal echocardiography. 24 cases were successful and 1 case was double hole atrial septum defect. After macroforamen closure, the microforamen did not completely cover the residual 5mm septum blood flow. The surgical side thoracotomy was successful. No radiation was used in 25 patients, compared with 73 consecutive patients with conventional closure of atrial septum defect under radiation, the basic data were compared with those of 73 consecutive patients with conventional transcatheter closure of atrial septum defect (ASD). There was no significant difference in hospitalization time (p0.05), but the operation time and bed rest time were significantly shorter than those in the control group (p 鈮，
本文编号：2487880
[Abstract]:Objective to study the value of esophageal echocardiography guided (TEE) in interventional closure of atrial septum defect (ASD) and ventricular septum defect (VSD). To explore the feasible materials and methods the clinical data of patients undergoing transcatheter closure of ventricular septum defect under the guidance of esophageal echocardiography in Zhengzhou University people's Hospital (Henan Provincial people's Hospital) from November 2013 to February 2016 were analyzed retrospectively. the clinical data of patients undergoing transcatheter closure of ventricular septum defect under the guidance of esophageal echocardiography were analyzed retrospectively. To summarize the skills and key points of transcatheter closure of atrial and ventricular septum defects under the guidance of esophageal echocardiography. Research: 1. The feasibility of transcatheter closure of atrial septum defect under the guidance of esophageal echocardiography; 2. The feasibility of interventional closure of atrial septum defect through internal jugular vein under the guidance of esophageal echocardiography; 3. The feasibility of transcatheter closure of ventricular septum defect by retrograde catheterization through femoral artery under the guidance of esophageal echocardiography. Patients with conventional atrium and ventricular septum defect were treated with continuous radiation at the same time from operation time, success rate, how much radiation and contrast agent were used, complications, bed rest time, The duration of hospitalization and the results of short-term follow-up after operation were compared to determine the clinical value of transcatheter closure of ventricular septum defect guided by esophageal echocardiography. All 21 patients were successfully treated with transcatheter closure of atrial septum defect under the guidance of esophageal echocardiography, and no radiation was used during the operation, compared with 73 consecutive patients with conventional closure of atrial septum defect under radiation at the same time. There was no significant difference in success rate, operation time, hospitalization time and postoperative complications (p0.05). Interventional closure of atrial septum defect was performed through internal jugular vein in 25 cases under the guidance of esophageal echocardiography. 24 cases were successful and 1 case was double hole atrial septum defect. After macroforamen closure, the microforamen did not completely cover the residual 5mm septum blood flow. The surgical side thoracotomy was successful. No radiation was used in 25 patients, compared with 73 consecutive patients with conventional closure of atrial septum defect under radiation, the basic data were compared with those of 73 consecutive patients with conventional transcatheter closure of atrial septum defect (ASD). There was no significant difference in hospitalization time (p0.05), but the operation time and bed rest time were significantly shorter than those in the control group (p 鈮，
本文编号：2487880
本文链接：https://www.wllwen.com/yixuelunwen/xxg/2487880.html
最近更新
教材专著
