卵圆孔未闭介入封堵预防隐源性脑卒中复发

doi:10.3969/j.issn.1004-583X.2020.01.004

摘要/Abstract

摘要： 目的探究卵圆孔未闭(PFO)封堵治疗的安全性、有效性，进一步讨论介入封堵治疗PFO的临床意义。方法选取2019年1-7月我院行PFO介入封堵术的PFO患者90例，术前所有患者均行经胸超声心动图右心声学造影（cTTE）及经食道超声心动图（TEE）证实为卵圆孔未闭并存在右向左分流。封堵成功即刻予床旁经胸超声心动图（TTE），观察封堵器及分流情况。术后3个月，行cTTE及颅脑CT。结果所有患者均成功置入封堵器，即刻经胸超声心动图证实封堵器位置正常，二、三尖瓣功能正常，未见残余分流，均未出现术中、术后并发症。术后随访3个月，58.9%患者头痛症状完全消失，34.4%患者头痛症状明显改善，发作频率较前明显减少，总的有效率为93.3%。术前27例一侧肢体麻木乏力患者中19例术后肢体麻木乏力症状完全消失，8例肢体麻木乏力症状虽未完全消失但较前不同程度缓解；术前8例恶心呕吐患者，术后症状完全消失。术后3个月复查经胸壁超声心动图右心声学造影示阳性率为5.6%（5/90）。术后3个月复查颅脑CT，提示本研究中90例患者均未发现新发梗死灶，再发脑卒中发生率为0%。结论介入封堵治疗PFO可明显缓解患者临床症状，解除患者痛苦，减少分流量，降低脑卒中的再发风险，是一种安全、有效的治疗方法，对PFO的治疗具有指导意义。

关键词: 心脏缺损, , 先天性, 卵圆孔, 未闭, 超声检查, , 介入性

Abstract: Objective To explore the safety and effectiveness of patent foramen ovale(PFO) closure, and further discuss clinical significance of interventional closure of PFO.Methods Totally 90 patients receiving PFO interventional closure in our hospital from January to July in 2019 were selected.All patients received transthoracic echocardiography (cTTE) and transesophageal echocardiography (TEE) to confirm the presence of right to left shunt with PFO.The successful occlusion was immediately performed by bedside transthoracic echocardiography (TTE), and the blocking device and shunt were observed.Three months after the operation, transthoracic echocardiography (cTTE) and brain CT were performed.Results All patients were successfully placed with the occlusive device, and transthoracic echocardiography immediately confirmed that the occlusive device was in normal position, the mitral valve and tricuspid valve function were good, no residual shunt was observed, and no intraoperative or postoperative complications occurred.After the follow-up of threemonths, headache symptoms completely disappeared in 58.9% of the patients, significantly improved in 34.4% of the patients, and the frequency of attack was significantly lower than before.The total effectiveness was 93.3%. Among the 27 patients with unilateral limb numbness and fatigue before the operation, 19 patients showed complete disappearance of limb numbness and fatigue symptoms after the operation, and eight patients showed different degrees of remission of limb numbness and fatigue symptoms although they did not completely disappear.Before the operation, eightcases with nausea and vomiting, postoperative symptoms completely disappeared.The positive rate of right echocardiography by transthoracic echocardiography at three months after surgery was 5.6%(5/90).The reexamination of brain CT three months after surgery indicated that no new infarction was found in all 90 patients in this study, and the incidence of recurrent stroke was 0%.Conclusion Interventional closure therapy for PFO can definitely relieve the clinical symptoms and pain of patients, reduce residual shuntand the risk of recurrent stroke. It is a safe and effective treatment method, which has a guiding significance for the treatment of PFO.

Key words: heart defects, , congenital, foramen ovale, , patent, ultrasonography, , interventional

张航, 马杰, 马千里, 安景辉, 李璐瑜, 张洁琼, 石凤梧. 卵圆孔未闭介入封堵预防隐源性脑卒中复发[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2020.01.004.

Zhang Hang, Ma Jie, Ma Qianli, An Jinghui, Li Luyu, Zhang Jieqiong, Shi Fengwu. Prevention of recurrence of cryptic stroke by interventional closure of patent foramen ovale[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2020.01.004.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2020.01.004

https://huicui.hebmu.edu.cn/CN/Y2020/V35/I1/28

[1]	张学谦, 李阳, 徐国栋, 吕佩源. 卵圆孔未闭所致急性脑梗死患者人口学特征、临床及影像学等特征分析[J]. 临床荟萃, 2023, 38(6): 500-503.
[2]	沈雪娇, 李燕, 王挺, 王媛. 痛风性关节炎血管内皮功能及其与血尿酸水平的相关性[J]. 临床荟萃, 2023, 38(3): 241-244.
[3]	曾学英, 尹万红, 周然, 邹同娟, 秦瑶, 王小亭, 晁彦公, 戴小容. 庖丁解牛-重症超声检查融合多元监测掌握重症之肺[J]. 临床荟萃, 2023, 38(2): 175-180.
[4]	李志勇. 超声诊断短暂颈动脉周围炎症综合征1例并文献复习[J]. 临床荟萃, 2023, 38(11): 1027-1030.
[5]	伊鑫, 刘灿章, 刘强, 王聪, 高腾, 闫杰. 冠心病患者合并焦虑抑郁对冠状动脉斑块成分及性质的影响[J]. 临床荟萃, 2023, 38(1): 50-54.
[6]	刘玉清, 程佶. 家族性Holt-Oram综合征1例并文献复习[J]. 临床荟萃, 2023, 38(1): 71-74.
[7]	崔清洋, 杨勇晖, 胡劲涛, 桑桂梅, 孙亚洲, 李雯, 贺晓日. 新生儿22q11.2缺失综合征5例临床及基因分析[J]. 临床荟萃, 2022, 37(6): 534-538.
[8]	李莉, 白璐, 孙明裕, 张世阳. D型人格对成人先天性心脏病患者死亡率影响的队列研究[J]. 临床荟萃, 2022, 37(5): 418-421.
[9]	刘芮汐, 易岂建. 血小板体积及分布宽度检测儿童川崎病价值[J]. 临床荟萃, 2021, 36(9): 824-827.
[10]	尹晓康, 张继平, 朱育刚, 申红霞, 王德峰. 恩格列净对2型糖尿病合并冠心病患者心室重构的影响[J]. 临床荟萃, 2021, 36(8): 713-718.
[11]	马桂兰, 敏菊. 肺超声联合血清NT-proBNP、sFlt-1对急性呼吸窘迫综合征患者病情严重程度及预后评估价值[J]. 临床荟萃, 2021, 36(12): 1110-1113.
[12]	王超, 万多, 李卅立, 王曦. 颈动脉多普勒超声对慢性肾病患者动脉粥样硬化程度及血流动力学的评估价值[J]. 临床荟萃, 2021, 36(11): 1009-1012.
[13]	吕怡萱, 卢展飞, 孙念哲, 李福翰, 刘蓉. 双能CT和超声诊断痛风效能的系统评价[J]. 临床荟萃, 2021, 36(1): 5-7.
[14]	刘炀，向海燕，刘伦志. 维生素K依赖性基质Gla蛋白与慢性肾脏病患者的血管钙化[J]. 临床荟萃, 2020, 35(9): 857-860.
[15]	张怡然. 甲状旁腺功能减退性心肌病的系统综述[J]. 临床荟萃, 2020, 35(9): 783-787.

卵圆孔未闭介入封堵预防隐源性脑卒中复发

Prevention of recurrence of cryptic stroke by interventional closure of patent foramen ovale

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价