卵圆孔未闭封堵术的近期疗效分析

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1、授予单位代码10089学号或申请号20153241中国图书分类号R541.1HebeiMedicalUniversity硕士学位论文专业学位卵圆孔未闭封堵术的近期疗效分析研究生：杨静云导师：石凤梧教授专业：外科学二级学院：河北医科大学第二医院2018年3月目录中文摘要···········································································1英文摘要·········································································

2、··2英文缩写········································································4研究论文卵圆孔未闭封堵术的近期疗效分析前言·················································································5材料及方法········································································6结果························

3、····················································8附图·············································································10附表·············································································11讨论······································································

4、·········12结论··········································································14参考文献·····································································15综述卵圆孔未闭介入封堵治疗偏头痛的研究进展··························17致谢········································································

5、··34个人简历·····································································35中文摘要卵圆孔未闭封堵术的近期疗效分析摘要目的：通过比较患者经卵圆孔未闭（PFO）介入封堵术治疗前、后临床症状的改善程度，评估卵圆孔未闭封堵治疗的近期临床疗效。方法：选取12例PFO患者（12例均患有脑卒中，其中8例合并偏头痛）行PFO介入封堵术，术前所有患者均经食道超声心动图（TEE）及经食道超声心动图右心声学造影（C-TEE）证实卵圆孔未闭并存在右向左分流。封堵成功即刻予床旁经胸超声心动图（TTE）及经胸超声

6、心动图右心声学造影（C-TTE），观察封堵伞及分流情况。术后30天行TTE及C-TTE，术后90天行TTE、C-TTE及头颅CT。偏头痛的患者术前、术后30天、术后90天行头痛影响测定-6（HIT-6）评分。结果：所有患者均成功置入封堵器。术后1例患者出现心律失常：窦性心动过缓，予对症治疗后恢复正常。所有患者封堵术后TTE及C-TTE检查发现封堵器无偏移，形态位置良好，与各瓣膜之间无功能上影响，1例患者卵圆孔存在少量右向左分流（RLS），随时间迁移，分流消失，余患者均未见残余分流。8例偏头痛患者术后30天、90天偏头痛症状得到显著改善（P<0.05）。术后90天头颅C

7、T均未发现新发梗死病灶，所有患者无再发脑卒中。结论：卵圆孔未闭与神经系统疾病（如：脑卒中、偏头痛）关系密切。PFO介入封堵术可预防脑卒中，改善偏头痛症状，提高患者生活质量，PFO介入封堵手术无严重并发症出现，手术安全、疗效确切，可作为当前治疗部分偏头痛合并卵圆孔未闭患者的首选治疗方法。对于合并PFO的患者，如手术适应症明确可考虑行介入封堵手术。关键词：卵圆孔未闭,偏头痛,脑卒中,介入封堵术,临床疗效1英文摘要Analysisoftheshort-termresultsofpatentofpatentforamenovaleABSTRACTObject