儿童先天性心脏病介入治疗436例临床分析

目的总结儿童先天性心脏病介入治疗的临床经验，分析其疗效。方法2007年1月至2013年6月新疆维吾尔自治区人民医院北院共施行0～14岁儿童先天性心脏病介入封堵治疗436例，其中继发孔型房间隔缺损213例，室间隔缺损83例，动脉导管未闭139例，房间隔缺损合并动脉导管1例。房间隔缺损、室间隔缺损及动脉导管未闭封堵术均采用Amplatzer法。结果全组患儿无手术死亡病例，封堵成功423例（97．4％），房间隔缺损组、室间隔缺损组和动脉导管未闭组的成功封堵率分别为97．7％（208／213），94．0％（79／83），98．6％（137／139）。室间隔缺损封堵术后早期心律失常发生率较高（15．2％）。全组门诊心脏超声心动图、心电图、胸部X线片随访3-36个月，无残余分流、死亡及严重心脏事件。结论经导管介入治疗先天性心脏病创伤小、安全、可靠、成功率高，部分患者可替代外科手术。

Clinical analysis of interventional therapy for 436 children with congenital heart disease

Objectives To evaluate the therapeutic effect of intervention treatment for children with congenital heart disease （CHD）. Methods From January 2007 to June 2013, 436 children aged from 0-14 years old with CHD at North Court Affiliated People＇s General Hospital of Xinjiang Uygur Autonomous Region received intervention treatment, and the clinical data of them were retrospectively analyzed. Of these patients, 213 cases were with atrial septal defect （ASD）, 83 with ventricular septal defect （VSD）, 139 with patent ductus arteriosus （PDA） and 1 with ASD combined with PDA. Amplatzer occluders were used in these patients. Results Totally 423 patients were successfully performed （97.4 % ） intervention treatment. The successful rates of transcatheter closure were 97.7% （208/213） in ASD group, 94.0% （79/ 83） in VSD group and 98.6% （137/139） in PDA group. The incidence rate of arrhythmia after procedure in VSD group （15.2%） was higher. There were no residual shunts, death or other severe complications in 3 to 36 months＇ follow-up. Conclusions Intervention treatment of CHD is less traumatic, with low complication rate and good efficacy. It is a promising alternative strategy to surgery in some patients.