经皮肺动脉瓣球囊扩张治疗先天性肺动脉瓣狭窄临床应用研究

目的：评价经皮球囊成形术（PBPV）治疗肺动脉瓣狭窄（PS）的临床疗效。方法：20例病人,经临床、心电图、胸片及心脏超声诊断为单纯肺动脉瓣狭窄,扩张前确定PS的类型和测量瓣环大小,球囊直径选择比瓣环直径大20%～40%,扩张后即刻测肺动脉跨瓣压差,观察PBPV后,肺动脉瓣的开放,射流,跨瓣压差,三尖瓣及肺动脉瓣返流情况。结果：20例患者均用球囊扩张成功,跨瓣压差下降63.65%（P〈0.01）,1例出现肺动脉瓣轻度关闭不全,1例术中出现窦缓,用阿托品后消失,无任何严重并发症发生。结论：PBPV治疗肺动脉瓣狭窄具有成功率高、创伤小、并发症少等特点,可作为治疗PS的首选方法。

Clinical applied research of percutaneous balloon pulmonary valve for congenital pulmonary valve stenosis

Objective： To evaluate the clinical efficacy of percutaneous balloon pulmonary valvuloplasty（PBPV） for pulmonary valve stenosis（PS）.Methods： 20 patients,through clinical,ECG,chest X-ray and cardiac ultrasound,were diagnosis as pure PS.Before PBPV,determination PS＇s type and valve annulus size,to select balloon diameter larger than its about 20%~40%.After balloon expansion instantly measured pulmonary pressure gradient,and observed the pulmonary valve open,ejection,pressure gradient,tricuspid and pulmonary valve regurgitation after PBPV.Results： All 20 patients were successful with the balloon dilation,pressure gradient decreased 63.65%（P0.01）,1 patients had mild pulmonary valve regurgitation,and 1 case in intraoperative occurred sinus bradycardia and disappeared by using atropine,no any serious complications.Conclusion： PBPV treatment for pulmonary valve stenosis with a high success rate,little trauma and few complications,and could be the first choice for PS treatment.