二维超声心动图对先天性心脏病介入治疗效果的评价(摘要)
作者：徐大地 钱晋卿 陈秀玉 王舒 华仰德 黄敏
单位：上海市，儿童医院 心内科(200040)
关键词：
目的 目的：应用二维超声心动图对先天性心脏病介入治疗效果进行评价。
方法：应用导管介入治疗先天性心脏病69例，年龄自1月～16岁(平均5.8岁)。其中动脉导管未闭(PDA)(组1)53例，肺动脉狭窄(PS)(组2)13例，大动脉移位(组3)3例。二维超声心动图结合多普勒技术和彩色多普勒血流显象，分别在介入治疗后及术后1个月、2个月、6个月、1年、2年，最长为6年作追踪随访。组1应用海绵塞法关闭44例，年龄自8～16岁(平均10.5岁)；弹簧圈法关闭7例，年龄5～12岁(平均8.3岁)；蘑菇伞法2例(平均6.5岁)。组2中应用经皮球囊肺动脉瓣成形术(PBPV)：单球囊法10例；双球囊法1例；球囊加改良Park带刀导管切开法2例。组3中球囊导管心房间隔缺损成形术(BAS)2例；球囊加改良Park带刀导管切开术1例。
, 百拇医药
结果：PDA介入治疗后有残余分流3例(5.7%);海绵塞法1例，2个月后复查分流消失；弹簧圈法2例；1例于术后2个月随访分流消失；另1例因分流量较大于术后2个月第2次弹簧圈堵闭成功；蘑菇伞法2例均无术后残余分流。PS 13例介入治疗后均留有轻度狭窄。但右心室与肺动脉间平均压力阶差由术前87.8 mmHg(1 mmHg=0.133 kPa),术后降低至28.34 mmHg,本组选择球囊直径/肺动脉瓣环直径为1.4～1.5,1例双球囊法者两者比例>1.5,术后伴发轻度肺动脉瓣反流。另1例因肺动脉瓣增厚，加用改良Park带刀导管切割后疗效满意。TGA 3例经介入治疗后血氧饱和度(SO2)自术前0.47至术后上升为0.79,临床症状明显改善，为以后进一步纠治准备条件。1例5个月患儿因心房间隔较厚，加用改良Park带刀导管切开心房间隔后，临床明显改善，心房间隔缺损由术前5 mm至术后增大为11 mm。
结论：二维超声心动图为评价先天性心脏病介入治疗效果的便捷、安全和准确的方法。
, 百拇医药
Two-Dimensional Echocardiographic Studies on Therapeutic Effect of Catheter Intervention on Congenital Heart Diseases (Abstract)
Department of Cardiology, Shanghai Children′s Hospital, Shanghai (200040)
Xu Dadi, Qian Jinqing, Chen Xiuyu, et al.
Objective: To evaluate the therapeutic effect of catheter intervention on congenital heart diseases with two-dimensional echocardiolgraphy (2DE).
, http://www.100md.com
Methods: Sixty-nine cases of congenital heart disease (CHD), aged from 1 month to 16 years (mean 5.8 years), including patent ductus arteriosus (PDA) in 53 (group 1), pulmonary stenosis (PS) in 13 (group 2), and transposition of great arteries (TGA) in 3 (group 3) were studied by 2DE with Doppler technique and color doppler flow imaging (CDFI) after catheter intervention. The follow-up terms were 1 day, 1, 2, 6 months 1, 2 and 6 years after intervention. In group 1, postman devices were used in 44 (aged from 8 to 16 years, mean 10.5 years); Cook coil devices in 7 (aged from 5 to 12 years, mean 8.3 years); Amplatzer devices in 2 (mean 6.5 years). In group 2, PBPV single balloon was used in 10, double balloon in 1, balloon plus modified Park blade catheter in 2. In group 3, BAS was used in 2, balloon plus modified Park blade catheter in 1.
, 百拇医药
Results: ① Three cases of PDA patients had residual shunts (5.7%), which disappeared two months later in 1 with postman device, the other with coil device. The third patient using coil device had relatively large residual shunt which was successfully occluded with cook coil on the second time two months later. Both two cases with Amplatzer devices had not any residual shunt. ② In all cases of PS after intervention, mild residual stenosis was present, but the mean pressure gradient between RV and PA decreased from 87.7 mmHg to 28.34 mmHg. The diameter ratio of balloon/PA valvular ring was 1.4～1.5. One of the 13 cases with double balloon devices had mild pulmonary insufficiency after the proceduce. One case with thicked pulmonary valves was treated successfully by PBPV plus modified Park blade catheter. ③ In all cases of TGA after intervention, mean oxygen saturation increased from 0.47 to 0.79. Clinical significant inprovement occured in a 5 months′ old baby after BAS with modified Park blade catheter, because of the thick inter-atrial septum, meanwhile ASD dilated from 5 mm befrom to 11 mm after the procedure.
Conclusion: Two-dimensional echocardiography is a safe, accurate and effective method for the evaluation of therapeutic effect of catheter intervention on CHD., 百拇医药
单位：上海市，儿童医院 心内科(200040)
关键词：
目的 目的：应用二维超声心动图对先天性心脏病介入治疗效果进行评价。
方法：应用导管介入治疗先天性心脏病69例，年龄自1月～16岁(平均5.8岁)。其中动脉导管未闭(PDA)(组1)53例，肺动脉狭窄(PS)(组2)13例，大动脉移位(组3)3例。二维超声心动图结合多普勒技术和彩色多普勒血流显象，分别在介入治疗后及术后1个月、2个月、6个月、1年、2年，最长为6年作追踪随访。组1应用海绵塞法关闭44例，年龄自8～16岁(平均10.5岁)；弹簧圈法关闭7例，年龄5～12岁(平均8.3岁)；蘑菇伞法2例(平均6.5岁)。组2中应用经皮球囊肺动脉瓣成形术(PBPV)：单球囊法10例；双球囊法1例；球囊加改良Park带刀导管切开法2例。组3中球囊导管心房间隔缺损成形术(BAS)2例；球囊加改良Park带刀导管切开术1例。
, 百拇医药
结果：PDA介入治疗后有残余分流3例(5.7%);海绵塞法1例，2个月后复查分流消失；弹簧圈法2例；1例于术后2个月随访分流消失；另1例因分流量较大于术后2个月第2次弹簧圈堵闭成功；蘑菇伞法2例均无术后残余分流。PS 13例介入治疗后均留有轻度狭窄。但右心室与肺动脉间平均压力阶差由术前87.8 mmHg(1 mmHg=0.133 kPa),术后降低至28.34 mmHg,本组选择球囊直径/肺动脉瓣环直径为1.4～1.5,1例双球囊法者两者比例>1.5,术后伴发轻度肺动脉瓣反流。另1例因肺动脉瓣增厚，加用改良Park带刀导管切割后疗效满意。TGA 3例经介入治疗后血氧饱和度(SO2)自术前0.47至术后上升为0.79,临床症状明显改善，为以后进一步纠治准备条件。1例5个月患儿因心房间隔较厚，加用改良Park带刀导管切开心房间隔后，临床明显改善，心房间隔缺损由术前5 mm至术后增大为11 mm。
结论：二维超声心动图为评价先天性心脏病介入治疗效果的便捷、安全和准确的方法。
, 百拇医药
Two-Dimensional Echocardiographic Studies on Therapeutic Effect of Catheter Intervention on Congenital Heart Diseases (Abstract)
Department of Cardiology, Shanghai Children′s Hospital, Shanghai (200040)
Xu Dadi, Qian Jinqing, Chen Xiuyu, et al.
Objective: To evaluate the therapeutic effect of catheter intervention on congenital heart diseases with two-dimensional echocardiolgraphy (2DE).
, http://www.100md.com
Methods: Sixty-nine cases of congenital heart disease (CHD), aged from 1 month to 16 years (mean 5.8 years), including patent ductus arteriosus (PDA) in 53 (group 1), pulmonary stenosis (PS) in 13 (group 2), and transposition of great arteries (TGA) in 3 (group 3) were studied by 2DE with Doppler technique and color doppler flow imaging (CDFI) after catheter intervention. The follow-up terms were 1 day, 1, 2, 6 months 1, 2 and 6 years after intervention. In group 1, postman devices were used in 44 (aged from 8 to 16 years, mean 10.5 years); Cook coil devices in 7 (aged from 5 to 12 years, mean 8.3 years); Amplatzer devices in 2 (mean 6.5 years). In group 2, PBPV single balloon was used in 10, double balloon in 1, balloon plus modified Park blade catheter in 2. In group 3, BAS was used in 2, balloon plus modified Park blade catheter in 1.
, 百拇医药
Results: ① Three cases of PDA patients had residual shunts (5.7%), which disappeared two months later in 1 with postman device, the other with coil device. The third patient using coil device had relatively large residual shunt which was successfully occluded with cook coil on the second time two months later. Both two cases with Amplatzer devices had not any residual shunt. ② In all cases of PS after intervention, mild residual stenosis was present, but the mean pressure gradient between RV and PA decreased from 87.7 mmHg to 28.34 mmHg. The diameter ratio of balloon/PA valvular ring was 1.4～1.5. One of the 13 cases with double balloon devices had mild pulmonary insufficiency after the proceduce. One case with thicked pulmonary valves was treated successfully by PBPV plus modified Park blade catheter. ③ In all cases of TGA after intervention, mean oxygen saturation increased from 0.47 to 0.79. Clinical significant inprovement occured in a 5 months′ old baby after BAS with modified Park blade catheter, because of the thick inter-atrial septum, meanwhile ASD dilated from 5 mm befrom to 11 mm after the procedure.
Conclusion: Two-dimensional echocardiography is a safe, accurate and effective method for the evaluation of therapeutic effect of catheter intervention on CHD., 百拇医药