[1]朱全伟 王宁 高明磊 刘大为 卢绪宁 崔琳 文平 刘宇航**.经胸超声心动图引导可调弯鞘右侧颈内静脉途径封堵小儿房间隔缺损[J].中国微创外科杂志,2019,01(10):878-881.
　Zhu Quanwei,Wang Ning,Gao Minglei,et al.Application of Adjustable Curved Sheath in Transcatheter Closure of Atrial Septal Defect With Internal Jugular Vein Guided by Transthoracic Echocardiography[J].Chinese Journal of Minimally Invasive Surgery,2019,01(10):878-881.
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经胸超声心动图引导可调弯鞘右侧颈内静脉途径封堵小儿房间隔缺损()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年10期
页码:
878-881
栏目:
临床研究
出版日期:
2019-10-25

文章信息/Info

Title:
Application of Adjustable Curved Sheath in Transcatheter Closure of Atrial Septal Defect With Internal Jugular Vein Guided by Transthoracic Echocardiography
作者:
朱全伟 王宁 高明磊 刘大为 卢绪宁 崔琳 文平 刘宇航**
（大连医科大学附属大连市儿童医院心外科，大连116012）
Author(s):
Zhu Quanwei;  Wang Ning;  Gao Minglei;  et al.
Department of Cardiothoracic Surgery, Dalian Children’s Hospital, Dalian 116012, China
关键词:
房间隔缺损; 可调弯鞘; 经胸超声心动图; 颈内静脉
Keywords:
Atrial septal defect; Adjustable curved sheath; Transthoracic echocardiography; Jugular vein
文献标志码:
A
摘要:
目的探讨经胸超声心动图（transthoracic echocardiography，TTE)引导可调弯鞘右侧颈内静脉途径封堵房间隔缺损（atrial septal defect，ASD）的安全性与有效性。方法纳入2016年3月~2018年9月27例ASD，年龄12~17(14.6±1.8)月，体重7.8~12.6(10.2±1.5)kg。ASD直径9.0~14.0(11.6±1.6)mm。在TTE引导下，使用新型可调弯鞘经右侧颈内静脉途径，实时调整鞘管的头端通过房间隔缺口，选择合适大小的封堵器进行封堵。结果27例ASD封堵过程顺利，均获成功，无一例改为放射线引导或中转开胸手术。手术时间18~26(22.1±2.3)min。术后住院时间2~5(3.5±1.2)d。无外周血管损伤、心内感染或心包积液等并发症。随访18~28（23.0±3.5）月，无心律失常、残余分流、封堵器脱落、血栓发生。结论在TTE引导下应用新型可调弯鞘经右侧颈内静脉途径封堵ASD具有适应证广、手术路径短、疗效好、创伤小、恢复快等特点，特别适合于年龄小、经股静脉治疗有难度的患儿。
Abstract:
ObjectiveTo investigate the application of adjustable curved sheath in transcatheter closure of atrial septal defect (ASD) with internal jugular vein solely guided by transthoracic echocardiography (TTE).MethodsFrom March 2016 to September 2018, there were 27 patients with ASD treated in our hospital. The age was 12-17 (14.6±1.8) months old. The body weight was 7.8-12.6 (10.2±1.5) kg. The ASD diameter was 9.0-14.0 (11.6±1.6) mm. Under the ultrasonic guidance, the head of the sheath tube was adjusted in real time, the suitable plugging device was selected, and the occlusion umbrella was released by the sheath tube. ResultsThe operations were completed successfully in all the patients. No conversion to open heart surgery or guidance by radioactive rays was required. The operation time was 18-26 (22.1±2.3) min. The length of postoperative hospital stay was 2-5 (3.5±1.2) d. There were no atrioventricular block, rhythm disturbances, or other types of major complications in the early postoperative period. The follow-up examination was for 18-28 (23.0±3.5) months. The post-operative follow-ups showed no residual shunt, falling off or detachment of occluders.Conclusion Application of adjustable curved sheath in transcatheter closure of atrial septal defect with internal jugular vein guided by transthoracic echocardiography has advantages of wide indications, short operation path, good curative effect, minimal invasion and fast recovery, especially suitable for young age children who are difficult to treat via femoral vein.

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备注/Memo

备注/Memo:
基金项目：辽宁省自然科学基金计划项目（201602886，20180550623）**通讯作者，E-mail：15524709667@163.com
更新日期/Last Update: 2020-01-09