经皮球囊肺动脉瓣成形术60例临床分析

目的 :通过对 60例接受经皮球囊肺动脉瓣成形术 (PBPV)的肺动脉瓣狭窄 (PS)患儿临床分析以评价PBPV治疗PS的安全性和有效性。方法 :选择单纯型PS患儿 60例 ,均常规进行PBPV治疗 ,比较PBPV前后患儿肺动脉瓣跨瓣压差 (PG)和肺动脉瓣上最大流速 (Vmax)等血流动力学指标及心脏体征变化并进行 6个月 ,12个月及长期随访。结果 :5 9例患儿经PBPV治疗全部成功且无明显并发症 ,仅 1例因肺动脉瓣发育不良PBPV后效果差行外科手术治疗。 5 9例患儿PBPV后PG和Vmax均较术前明显降低 ( 76.3 6vs 2 5 .0 6mmHg ,4 4 5 .16vs 2 71.4 7cm s ,P <0 0 1)且PBPV后心脏杂音明显减轻。在术后 6个月 ,12个月及长期随访中 ,PG和Vmax与术前相比有明显差异 ,无再狭窄发生。术后 6～ 12个月内PS继发的右心扩大和右室肥厚恢复至正常水平。结论 :经皮球囊肺动脉瓣成形术治疗单纯型肺动脉瓣狭窄疗效肯定、安全且远期预后好 ,是PS的首选治疗方法

Clinical analysis in patients with pulmonary valve stenosis treated with percutaneous balloon pulmonary valvuloplasty

Objective:To evaluate the safety and effectiveness of percutaneous balloon pulmonary valvuloplasty(PBPV)in patients with pulmonary valve stenosis.Method:60 cases with simple pulmonary valve stenosis were selected.All patients received PBPV.Hemodynamic markers including pulmonary valve pressure difference and velocity and heart murmur were compared before and after PBPV.All patients were followed at 6,12 months and long term.Result:59 cases received PBPV successfully and without any complication.Only 1 case received surgery therapy after PBPV because of valve malfunction.Of 59 cases pulmonary valve pressure(PG) difference and pulmonary valve velocity(V max )were significantly lower after PBPV(76.36 vs 25.06 mmHg, P <0 001;445.16 vs 271.47 cm/s, P <0 01)and the heart murmur were significantly relieved after PBPV.There were significant difference of PG and V max between long term follow|up and before PBPV.There were no child with restenosis.Right heart dilation and right ventricular hypertrophy caused by PS were up to normal at 6～12 months after PBPV.Conclusion:PBPV was an effective and safe method and had good effect at long term in treating simple pulmonary valve stenosis. [