陈火元,朱鲜阳,盛晓棠,张端珍,王琦光,韩秀敏,崔春生,庚靖淞

• 1:沈阳军区总医院全军心血管病研究所先心病内科

摘要(Abstract)：

目的评价带孔(8 mm)房间隔缺损封堵器(ASO)治疗房间隔缺损(ASD)合并重度肺动脉高压(PAH)的疗效。方法选取沈阳军区总医院2002年9月至2013年4月收治的17例(男1例,女16例)ASD合并重度PAH患者,采用带孔ASO行介入封堵,术后随访时间为1.5~12(6.4±2.7)年,收集肺动脉压(PAP)、右心室舒张末期内径(RVEDd)、左心室舒张末期内径(LVEDd)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)和左心室射血分数(LVEF)。结果封堵前右心导管检查肺动脉收缩压(s PAP)60~108(88.7±11.7)mm Hg(1 mm Hg=0.133 k Pa),平均肺动脉压(m PAP)29.3~60(51.0±8.1)mm Hg,肺循环血流量/体循环血流量(Qp/Qs)1.50~2.44(1.8±0.31),肺血管阻力(PVR)3.1~9.7(5.6±1.5)wood。置入带孔ASO直径为30~42(36±4.9)mm,封堵后s PAP 56~99(70±11.5)mm Hg,m PAP 27~51.7(41.1±7.1)mm Hg,较术前均有显著下降(P<0.05)。术后3 d和3、6个月RVEDd缩小(P<0.05),LVEDd、LVEDV、LVEF均增大(均P<0.05)。术后3、6个月的s PAP分别为50~78(61.6±7.5)mm Hg和46~68(55.9±5.7)mm Hg,较术前均有显著下降(均P<0.05);中远期s PAP为45~100(60.2±13.3)mm Hg,较封堵前显著下降(P<0.05),但与术后6个月比较,差异无统计学意义(P>0.05)。结论采用带孔ASO封堵ASD合并重度PAH效果较好,是治疗ASD合并重度PAH的理想方法。

关键词(KeyWords)： 先天性心脏病;房间隔缺损;肺动脉高压;带孔房间隔缺损封堵器

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 陈火元,朱鲜阳,盛晓棠,张端珍,王琦光,韩秀敏,崔春生,庚靖淞

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