经皮球囊肺动脉瓣成形术治疗肺动脉瓣狭窄临床观察.doc

《经皮球囊肺动脉瓣成形术治疗肺动脉瓣狭窄临床观察.doc》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、经皮球囊肺动脉瓣成形术治疗肺动脉瓣狭窄临床观察(附16例报告)ClinicalObsenationonPatientswithPSAfterPercutaneousBallonPulmonary7Valvuoplasty于连慧高丽芳刘和平孟繁超付续杰王玉库薛国宏蒋宝国YuLianhuiGaoLifangLiuHepingMengFanchaoFuXujieWangYukuXueGuohongJiangBaoguo吉林心脏病医院吉林省心脏病研究所JilinHeartDiseaseHospital&H

2、eartDiseaseInstituteinJilinProvince中图分类号：文献标识码：文章编号:1818・0086(2011)06摘38泪的观察经皮球囊肺动脉瓣成形术治疗肺动脉瓣狭窄(percutaneousballoonpulmonaryvalvuoplasty.PBPV)术前、术后肺动脉一右心室收缩压峰值压差的变化，以评估手术效果。方法2004~2007年吉林心脏病医院心内科诊治16例肺动脉瓣狭窄的患者，年龄3-57岁。首先通过右室左侧位造影，根据肺动脉瓣环直径选择扩张球囊;用右心导管

3、测肺动脉一右心室收缩压峰值压差及心脏彩超多普勒测跨肺A瓣压差的方法分别测定扩张前、后压差变化；并于术后随访平均(23.2+12.4)月，以心电图、超声心动、X线为随访指标。结果16例PBPV患者术后即刻肺动脉一右心室收缩压峰值压力阶差由术前的(39~203)mmHg降至(2-95)mmHg(P<0.01),术后心脏彩超多普勒测跨肺动脉瓣压差由术前的(34~179)mmHg降至(4~48mmHg)(P<0.05)。术后(23.2+12.4)月多普勒测跨肺动脉瓣压差与术前相比差异有显著性(P<0.05

4、)o结论经皮肺动脉瓣成形术可显著缩小压差，其治疗肺动脉瓣狭窄安全，疗效确切，创伤小，恢复快。关键词：肺动脉瓣狭窄；成形术AbstractObjectivesToevaluatetheoperationeffectbyobservingthepressurechangeinpulmonaryarteryandrightventriclebeforeandafterPBPVinpatientswithpulmonaryvalvestenosis.Methods16patientswithpulmona

5、ryvalvestenosiswerestudied・Cardiaccatheterizationwereperformedbyselectedballoondependingondiameterofpulmonaryvalve;thepressuresofpulmonaryarteryandrightventricleweremeasuredbeforeandafteroperationbybothcardiaccatheterizationandechocardiaography.Allpat

6、ientswerefollowedup23.2+_12.4monthsbyECG,EchocardiographyandX-ray.ResultsComparedtopre-operation,post-operationpressurediffereneebetweenpulmonaryarteryandrightventriclewassignificantlydecreasedfrom39-203mmHgto2-95mmHg(p<0.01),thepressurediffereneemess

7、uredbycolorDopplerweresignificantlydecreasedfrom34-179mmHg(pre-operation)to4-48mmHg(P<0.05).Thepressurediffereneeofbothsidesofpulmonaryvalveweresignificantlydecreased23.2+_12.4monthslatercomparedtopre-operation.（P<0.05）.ConclusionPBPVisasafeandeffecti

8、vemethodtocurepulmonaryvalvestenosisbydecreasingpressurediffereneebetweenpulmonaryarteryandrightventricle.Keywords:Pulmonaryvalvestenosis;Percutaneousballonpulmonaryvalvuoplasty肺动脉瓣狭窄是常见的先天性心脏病，约占所有先天性心脏病7%-10%o80年代前的治疗方法是经右心室闭式手术瓣膜分离或体外循环直视下手