丁建,李占全

• 1:辽宁省人民医院心血管内科

摘要(Abstract)：

目的总结儿童(年龄≤14岁)梗阻性肥厚型心肌病(HOCM)患者行经皮室间隔心肌化学消融术(PTSMA)治疗的并发症发生情况及临床疗效,初步探讨儿童HOCM患者行PTSMA的疗效和安全性。方法对2004年3月-2012年6月辽宁省人民医院行PTSMA治疗的4例儿童HOCM患者的临床资料和化学消融结果进行回顾性分析,总结其化学消融术中和术后围术期并发症的发生情况及疗效。结果 4例接受PTSMA治疗的儿童HOCM患者,术后比术前静息左心室流出道压力阶差明显下降,但差异无统计学意义(P>0.05),术后比术前早搏后左心室流出道压力阶差明显降低,差异有统计学意义(P<0.05)。病例1发生Ⅲ度房室传导阻滞,病例2术中发生完全性右束支传导阻滞,均治愈。所有患儿均随访12个月,无严重临床事件发生。结论儿童HOCM患者行PTSMA治疗是有效的。PTSMA可能是治疗儿童HOCM患者的方法之一。

关键词(KeyWords)： 梗阻性肥厚型心肌病;经皮室间隔心肌化学消融术;儿童

Abstract:

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基金项目(Foundation):

作者(Author): 丁建,李占全

参考文献(References)：

• [1]Roberts R,Sigwart U.Current concepts of the pathogenesis andtreatment of hypertrophic cardiomyopathy.Circulation,2005,112:293-296.
• [2]Morentin B,Suárez-Mier MP,Aguilera B,et al.Myocardial disease mortality in children and young adults:A population-based observational study.Rev Esp Cardiol,2006,59:238-246.
• [3]Li Z Q,Cheng T O,Zhang W W,et al.Percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy:The Chinese experience in 119 patients from a single center.Int J Cardio,2004,93:197-202.
• [4]Saccheri MC,Cianciulli TF,Konopka IV,et al.Usefulness of pulsed Doppler tissue imaging in the early detection of diastolic myocardial abnormalities in first-degree relatives of patients with familial hypertrophic cardiomyopathy.Rev Esp Cardiol,2006,59:41-49.
• [5]Pokorski RJ.Hypertrophic cardiomyopathy:risk factors for lifeand living entfi ts insurance.J Insur Med,2002,34:43-60.
• [6]Sigwart U.Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy.Lancet,1995,346:211-214.
• [7]Zhang W,Li Z,Zhang M,et al.Complications of percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy.Chin Med J(Engl),2002,115:1283-1286.
• [8]李成洋,石蕴琦,李占全,等.化学消融联合经皮冠状动脉介入术治疗5例肥厚型梗阻性心肌病伴冠心病患者疗效分析.临床心血管病杂志,2010,26:151-152.
• [9]Veselka J,DuchonováR,Páleníckova J,et al.Impact of ethanol dosing on the long-term outcome of alcohol septal ablation for obstructive hypertrophic cardiomyopathy:a single-center prospective,and randomized study.Circ J,2006,70:1550-1552.
• [10]李成洋,张薇薇,李占全,等.70岁以上肥厚性梗阻型心肌病患者化学消融的安全性初探.中国循环杂志,2012,27:186-188.
• [11]辽宁省PTSMA治疗HOCM协作组.经皮经冠状动脉室间隔化学消融术治疗肥厚性梗阻型心肌病的近期疗效观察.中华心血管病杂志,2001,29:8-11.
• [12]李成洋,李占全,石蕴琦,等.18岁以下肥厚型梗阻性心肌病患者化学消融的近期疗效与安全性探讨.中国介入心脏病学杂志,2013,21:97-99.