经皮球囊肺动脉瓣成形术治疗肺动脉瓣狭窄临床观察.docVIP

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） Clinical Observation on Patients with PS After Percutaneous Ballon Pulmonary Valvuoplasty 于连慧 高丽芳 刘和平 孟繁超 付续杰 王玉库 薛国宏 蒋宝国 Yu Lianhui Gao Lifang Liu Heping Meng Fanchao Fu Xujie Wang Yuku Xue Guohong Jiang Baoguo 吉林心脏病医院 吉林省心脏病研究所 Jilin Heart Disease Hospital Heart Disease Institute in Jilin Province 中图分类号： 文献标识码： 文章编号：1818－0086（2011）06 摘 要：目的 观察经皮球囊肺动脉瓣成形术治疗肺动脉瓣狭窄（percutaneous balloon pulmonary valvuoplasty. PBPV）术前、术后肺动脉—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；用右心导管测肺动脉—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—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）。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 Abstract Objectives To evaluate the operation effect by observing the pressure change in pulmonary artery and right ventricle before and after PBPV in patients with pulmonary valve stenosis. Methods 16 patients with pulmonary valve stenosis were studied. Cardiac catheterization were performed by selected balloon depending on diameter of pulmonary valve; the pressures of pulmonary artery and right ventricle were measured before and after operation by both cardiac catheterization and echocardiaography. All patients were followed up 23.2+_12.4 months by ECG, Echocardiography and X-ray. Results Compared to pre-operation, post-operation pressure difference between pulmonary artery and right ventricle was significantly decreased from 39-203mmHg to 2-95 mmHg(p0.01), the pressure difference messured by color Doppler were significantly decreased from 34-179mmHg ( pre-operation) to 4-48mmHg (P0.05). The pressure difference of both sides of pulmonary valve were significantly decreased 23.2+_12.4 months later compared to pre-operation. (P0.05). Conclusion PBPV is a safe