| 摘要: |
| 目的探讨肺血减少型复杂先天性心脏病姑息术后介入治疗的临床疗效及对跨肺动脉瓣压力阶差（PTG）、右室收缩压（RVSP）、肺动脉收缩压（PASP）、血氧饱和度（SaO2）的影响。方法选取2010年1月至2016年1月收治的肺血减少型复杂先天性心脏病姑息手术后介入治疗的患儿149例，对其进行回顾性分析，分析其临床效果与并发症情况，术前及术后即刻右心导管及造影检查PTG、RVSP、PASP及SaO2变化情况；随访12个月，观察肺动脉发育指标（Nakata指数、McGoon比值）、SaO2及PTG改善情况。结果149例患儿均顺利进行经皮球囊肺动脉扩张术，介入治疗手术成功率为100%，术后出现心律失常3例，2例患儿出现发热情况，并发症总发生率为3.36%；术后PTG、RVSP、PASP及SaO2均比术前明显改善（均P＜0.01）；术后1、3、6、12个月患儿Nakata、McGoon及SaO2呈上升趋势，均比术前明显改善，PTG则明显比术前下降（均P＜0.01）。结论对肺血减少型复杂先天性心脏病外科姑息术后进行介入治疗，有较好的临床效果，并可降低术后并发症，安全性高，并可有效促进肺血管发育及改善心室功能。 |
| 关键词: 姑息术后 肺血减少型复杂先天性心脏病 经皮肺动脉球囊扩张术 肺动脉狭窄 |
| DOI：10.12056/j.issn.1006-2785.2017.39.11.2017-189 |
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| Efficacy of interventional therapy in pediatric patients with complex congenital heart disease of diminished pulmonary blood flow after palliative surgery |
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ZENG Guangwei, SHANG Fujun, KANG Xiaojun, NIU Xiaolin, LIU Yin, WANG Chiyao, CHEN Wensheng
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Tangdu Hospital of the Fourth Military Medical University
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| Abstract: |
| Objective To evaluate the clinical efficacy of interventional therapy in pediatric patients with complex congenital heart disease of diminished pulmonary blood flow after palliative surgery. Methods One hundred and forty nine complex congenital heart disease pediatric patients with diminished pulmonary blood flow after palliative surgery were admitted in our hospital from January 2012 to June 2015. All patients received percutaneous balloon pulmonary artery dilatation, the pulmonary transvalvular gradient(PTG), right ventricle systolic pressure(RVSP), pulmonary arterial systolic pressure(PASP), and oxyhemoglobin saturation (SaO2) were measured by right cardiac catheterization before and after the intervention. Patients were followed up for 12 months, pulmonary artery development index (Nakata index, McGoon ratio), SaO2 and PTG were measured by the end of follow-up. Results The interventional procedures underwent smoothly in all 149 patients. There were 3 patients with arrhythmia and 2 patients with fever after operation with a perioperative complication rate of 3.36%. The PTG, RVSP, PASP and
SaO2 of patients were significantly improved after operation(P＜0.05); Nakata index, McGoon ratio and SaO2 of patients increased
significantly at 1, 3, 6 and 12 months after operation; and PTG of patients was significantly decreased compared with preoperative value (P＜0.05). Conclusion Interventional therapy after palliative surgery can reduce postoperative complications, and promote pulmonary vascular development and improve ventricular function effectively for children with complex congenital heart disease of diminished pulmonary blood supply. |
| Key words: Palliative treatment Complex congenital heart disease patients with diminished pulmonary blood disease Percutaneous pulmonary artery balloon dilatation Pulmonary stenosis |
