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Chin Circul J:<6月主动脉缩窄患儿不适于球囊扩张治疗

2017-04-01 朱朱 中国循环杂志

青岛妇女儿童医院邸勇等本刊发文报告,对于6个月以下的主动脉缩窄婴幼儿,球囊扩张治疗效果差,建议用外科手术治疗此类患儿。作者指出,主动脉缩窄球囊扩张对于是否适合婴幼儿治疗仍存在较大争议。目前,很多学者以为对于未曾外科手术治疗的局限性、隔膜型主动脉缩窄患儿球囊扩张效果明显。但作者发现:行球囊扩张后,患儿的主动脉狭窄段直径略有增长,HE 染色示其内层粘膜脱落,但中层平滑肌连续性完整,说明单纯球囊扩张效果

青岛妇女儿童医院邸勇等本刊发文报告,对于6个月以下的主动脉缩窄婴幼儿,球囊扩张治疗效果差,建议用外科手术治疗此类患儿。



作者指出,主动脉缩窄球囊扩张对于是否适合婴幼儿治疗仍存在较大争议。目前,很多学者以为对于未曾外科手术治疗的局限性、隔膜型主动脉缩窄患儿球囊扩张效果明显。

但作者发现:行球囊扩张后,患儿的主动脉狭窄段直径略有增长,HE 染色示其内层粘膜脱落,但中层平滑肌连续性完整,说明单纯球囊扩张效果差。

作者表示,随着医疗技术进步,外科手术治疗主动脉缩窄手术效果明显,各类并发症亦得到有效控制。该院收治的大多数患儿采用主动脉远端和主动脉弓下缘吻合的扩大端侧吻合术,术后发生狭窄的可能性更低。再狭窄、主动脉瘤、主动脉夹层及脊髓损伤等并发症亦控制在相当低的比例,术后随访效果满意,无再手术病例。

据报告,该院2011年至2015年共5年期间,共收治13例小于6个月的主动脉缩窄婴幼儿。其中8例患儿合并非限制性室间隔缺损(3 例行分期手术),2 例房间隔缺损,3 例主动脉瓣二瓣式,3 例动脉导管未闭,1例心包积液。

患儿术中切除主动脉狭窄段,对其采用狭窄段直径2~4倍经皮血管成形术外周球囊扩张。手术过程中留取13例主动脉缩窄患儿的主动脉狭窄段,其中9例为隔膜型,4 例为管型狭窄。

13例患儿中,男性9 例, 女性4 例,平均年龄3.4个月,平均体重4.8 kg。

原始出处:

邸勇,王葵亮,任悦义, 等. 小于六个月婴幼儿主动脉缩窄离体球囊扩张效果研究. 中国循环杂志, 2017, 32: 174-176.

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    2018-02-11 lsj637
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    2017-04-03 花花1366
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