论文部分内容阅读
为探讨瓣膜发育不良型肺动脉瓣狭窄(简称PS)球囊扩张术(简称PBPV)效果,采用超大球囊法为34例瓣膜发育不良型PS进行球囊扩张术。34例中轻型21例(平均年龄4.40岁),重型13例(平均年龄5.15岁),最小年龄11月。应用PBPV术球/瓣比值轻型1.36～1.64(平均1.41),重型1.20～1.64(平均1.52),术前后观察跨肺动肺瓣压差(△P),出院后随访多普勒超声心动图以监测△P。结果:轻型中18例(85.7％)效果良好(≤25mmHg),3例(14.3％)1年后△p回升>30mmHg需作第二次球囊扩张;重型中7例(53.8％)效果良好(△P≤25mmHg),其球/瓣比值达1.52±0.12;而术后△p>25mmHg6例(46.2％)球/瓣比值为1.27±2.26。结论:(1)瓣膜发育不良型病变程度是影响PBPV疗效的主要因素;(2)瓣叶明显增厚、充盈缺损、射流消失、无狭窄后扩张者疗效差,轻型疗效良好;(3)超大球囊法(球/瓣比值1.4～1.5)对轻型及部分重型病例获良好效果。
In order to investigate the effect of valvular dysplasia of pulmonary valve stenosis (referred to as PS) balloon dilatation (PBPV for short), 34 cases of valvular dysplasia type PS balloon dilatation were performed by the method of large balloon. Thirty-four cases were mild in 21 cases (mean age 4.40 years), heavy in 13 cases (mean age 5.15 years) and the youngest in November. The PBPV ball / flap ratio was 1.36 ~ 1.64 (average 1.41) and 1.20 ~ 1.64 (average 1.52) in the light of PBPV. The postprandial pulmonary artery pressure difference (△ P) To monitor △ P. RESULTS: Eighteen cases (85.7%) had good effect (≤25mmHg) in 3 cases (14.3%), and the second balloon dilatation after ΔP recovery> 30mmHg after one year was achieved in 7 cases (53.8%) in severe cases (△ P≤25mmHg), the ball / valve ratio reached 1.52 ± 0.12; and postoperative △ p> 25mmHg6 cases (46.2%) ball / valve ratio was 1.27 ± 2.26. Conclusions: (1) The degree of dysplasia of valvular dysplasia is the main factor affecting the curative effect of PBPV. (2) The valvular thickening, filling defect, disappearance of jet, poor curative effect of dilator without stenosis, Balloon method (ball / flap ratio 1.4 ~ 1.5) for light and some heavy cases of good results.