法洛三联症介入治疗的临床分析

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目的总结法洛三联症的介入手术治疗经验,并对其疗效进行初步评价。方法2004年8月~2005年7月共收治法洛三联症患者18例,年龄3~32(8.4±6.2)岁。所有病例均在透视及超声心动图监视下经导管肺动脉瓣球囊扩张术(PBPV)及置入国产双盘封堵器封堵房间隔缺损。全部患者于术后即刻、术后6个月分别行超声心动图、心电图、X线胸片检查评价治疗效果。结果全组治疗成功率100%,均无重要并发症发生,PBPV后即刻右室收缩压由(84±25)降至(40±10)mmHg(1mmHg=0.133kPa),肺动脉至右室跨瓣压由(67±26)降至(13.0±11.5)mmHg(P<0.01),超声心动图检测房间隔缺损直径为5~16(9.2±7.4)mm,选择的封堵器直径为8~20(13.0±9.2)mm,2例存在微量残余分流,16例封堵完全无残余分流。术后即刻、术后6个月超声心动图检测未见残余分流及再通。结论介入治疗法洛三联症是一种安全有效的方法,操作简便,成功率高,近期疗效可靠,中远期疗效尚需进一步观察。 Objective To summarize the experience of interventional treatment of trilogy of Fallot and to evaluate its efficacy. Methods From August 2004 to July 2005, 18 patients with triple illnesses were enrolled in this study, ranging in age from 3 to 32 (8.4 ± 6.2) years. All cases were under catheterization and echocardiography monitoring by catheter pulmonary valve balloon inflation (PBPV) and placement of domestic double disk occluder to occlude atrial septal defect. All patients were evaluated immediately after operation and 6 months after operation by echocardiography, electrocardiogram and X-ray. Results The success rate of the whole treatment was 100%, no significant complication occurred. Right ventricular systolic pressure immediately after PBPV decreased from (84 ± 25) to (40 ± 10) mmHg (1mmHg = 0.133kPa) (P <0.01). The diameter of atrial septal defect detected by echocardiography was 5 ~ 16 (9.2 ± 7.4) mm, and the diameter of the occluder selected was 8 ~ 20 (13.0 ± 9.2) mm, two patients had residual trace shunt, and 16 patients had no residual shunt completely. Immediately after surgery, 6 months after echocardiography showed no residual shunt and recanalization. Conclusion Interventional treatment of tetralogy of Fallot is a safe and effective method. It is easy to operate, has high success rate and reliable curative effect in the near future. The curative effect of long-term and long-term need to be further observed.
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