摘要
目的探讨单纯超声心动图引导下儿童房间隔缺损(atrial septal defect,ASD)的介入治疗安全性、有效性、可行性.方法2018年3月至2019年12月间我院收治ASD患儿92例,其中男性38例,女性54例,年龄(4.82±3.24)岁,体重(18.61±9.12)kg.心脏畸形均为ASD(其中1例合并动脉导管未闭,直径约1.8 mm,未予特殊处理),均行单纯超声心动图引导下ASD封堵术,其中81例患儿行经皮超声引导下ASD封堵术,7例患儿行经胸ASD封堵术,4例患儿麻醉后经食管超声心动图评估无需行手术治疗.术后常规予口服阿司匹林抗凝治疗6个月,每日3 mg/kg,预防血栓形成.术后即刻、1个月、3~6个月复查超声心动图及心电图,评估治疗效果.结果手术患儿均封堵成功,无封堵器脱落、心脏穿孔和外周血管损伤等并发症.术后随诊超声心动图及心电图提示封堵器位置好,各房室内径基本正常,未见残余分流、心包积液和心律失常等并发症.结论单纯超声心动图引导下儿童ASD应用介入治疗是安全有效的,且具有创伤小、恢复快、并发症少等优点.
Objective To investigate the safety,efectiveness and feasibility of the interventional therapy for atrial septal defect(ASD)guided by simple cardiac ultrasound in children.Methods A total of 92 children with ASD treated from March 2018 to December 2019 in our hospital were collected,including 38 males and 54 females,aged(4.82±3.24)years old,weighing(18.61±9.12)kg and all cardiac deformities were ASD(1 case with patent ductus arteriosus,about 1.8 mm in diameter,without special treatment).All the paticnts underwent simple cardiac ultrasound guided ASD occlusion,of which 81 patients underwent percutaneous ultrasound guided ASD occlusion.7 children underwent thoracic ASD closure and 4 children underwent esophageal echocardiographic evaluation without surgery.Oral Aspirin anticoagulation was routinely given at 3 mg/kg everyday for 6 months after the surgery to prevent thrombosis.Cardiac echocardiography and electrocardiogram were reviewed immediately 1 month and 3-6 months after surgery to evaluate the treatment effect.Results The children were scessfully occluded without any complications such as occluder detachment,cardiac perforation and peripheral vascular injury.The color Doppler ultrasound and electrocardiogram at the follow-up showed that the occluder was in a good position and the intemal diameter of cach room was basically normal.There were no complications such as residual shunt,pericardial effusion and arrhythmia.Conclusion The interventional treatment of ASD in children guided by simple echocardiogrophy is safe and efective and has the advantages of less trauma,faster recovery and fewer complications.
作者
伊寒露
叶赞凯
朱耀斌
郭健
丁楠
闫道乐
李志强
YHan-lu;YE Zan-kai;ZHU Yao-bin;GUO Jian;DING Nan;YAN Dao-le;LI Zhi-qiang(Second Department of Cardiac surgery,National Center for Children's Health,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China)
出处
《中国心血管病研究》
CAS
2020年第9期806-808,共3页
Chinese Journal of Cardiovascular Research
关键词
超声心动图
房间隔缺损
介入
儿童
Echocardiography
Atrial septal defect
Intervention
Children
