多孔性房间隔缺损介入治疗的临床分析

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1、北京协和医学院中国医学科学院硕士研究生毕业论文AbstractPart1ClinicalevaluationofTranscatheterClosureofMultipleAtrialSeptaiDefectswithaSingleAmplatzerDevice【Abstract】ObjectiveToclinicallyevaluatethetreatmentthattranscatheterclosureofmultipleatrialseptaldefectswithsingleAmplatzerdevice．Me

2、thodsGuidedbyundertheX-rayfluoroscopyandechocardiography,131patientswithatrialseptaldefects(2or3)underwentthetranscatheterocclusionofthesedefectswithsingleAmplatzeroccluder．Aftertheprocedure，patientswerecheckedwithelectrocardiography,X-raychestradiographyandechoc

3、ardiographytoevaluateitseffect．Results131patientswithmultipleatrialseptaldefects(121with2defects，10with3defects)，TEEduringproceduresshowedthatthemeandiameterofthelarge，mediumandsmalldefectswerel6．55±6．04mm，5．27±2．67milland3．70±1．34lnnl，respectively．Thelargerdista

4、ncebetweenthedefectswere7．30±4．35lnlTl．131Amplatzeroccludersweresuccessfullyimplantedwith272defectsclosed．Themeandiameterofoccluderswas25．0±6．63mm．62patientshadnoresidualshuntimmediatelyafterocclusion(completelyocclusionrate47．33％)；69patientshadresidualshunttosom

5、eextent，closureratewas56．49％(12patients’residualshuntweredisapeared)after24hoursand38patientswerefollowedup，closureratewas87．41％after12months．1patientsacceptedradiofrequencyablationafter4monthsbecauseofatrialflutter．Aftercomparingcardiac-thoracicrate，rightventric

6、ularinnerdiameteratthetimeof24hoursandtheultimatereviewwithpre-procedure，thisindicatesthatthecardiac—thoracicrateandrightventricularinnerdiameterdecreaseobviously(P<0．01)。Forpatientswiththelargerdistancebetweendefects>7mm，thediameteroftheseconddefecthasapositivec

7、orrelationwiththeextentoftheresidualshuntimmediatelyaftertheprocedure，correlationcoefficientiS0．578(p<0．05)．Forthedistancebetweendefects<7mm，thediameteroftheseconddefecthasnosignificantcorelationwithresidualshunt(P>0．05)．ConclusionItiSsafeandeffectiveoftranscathe

8、terclosureofmultipleatrialseptaldefectswithsingleAmplatzerocclude．Italsohasaratherhighclosurerateduringshort-timeandmiddle-timefollowup．[KeyWords】interventiona