经胸超声心动图监测引导在经皮卵圆孔未闭封堵术中的应用效果

张超; 韩冬; 范迪堃; 高建朝; 杨侃

doi:10.7619/jcmp.20232874

经胸超声心动图监测引导在经皮卵圆孔未闭封堵术中的应用效果

Application effect of transthoracic echocardiography monitoring in percutaneous closure of patent foramen ovale

摘要

摘要:
目的观察经胸超声心动图(TTE)监测引导在经皮卵圆孔未闭(PFO)封堵术中的应用效果。
方法回顾性分析98例PFO患者的资料, 患者均行介入封堵术。依据术中引导方式的不同分成X线组(n=50)和TTE组(n=48)。比较2组封堵情况、并发症发生情况、手术指标、右向左分流(RLS)分级情况以及合并偏头痛者的头痛改善情况。
结果 98例PFO均成功完成封堵, 其中TTE组有2例因术中声窗欠佳, 加用经食道超声引导。TTE组手术时间长于X线组, 差异有统计学意义(P < 0.05)。术后, 2组RLS分级及偏头痛者头痛影响测验-6(HIT-6)评分低于术前, 差异有统计学意义(P < 0.05)。
结论单纯TTE引导的经皮PFO封堵术对PFO患者RLS、偏头痛的改善效果较好, 且能规避X线对医患所造成的辐射损伤。

Abstract:
Objective To observe the effect of transthoracic echocardiography (TTE) monitoring in percutaneous closure of patent foramen ovale (PFO).
Methods The data of 98 patients with PFO were retrospectively analyzed. All patients underwent interventional plugging. They were divided into X-ray group (n=50) and TTE group (n=48) according to different intraoperative guidance methods. The occlusions, complications, surgical indexes, right-to-left shunt (RLS) grading and the improvement of headache in patients with migraine were compared between the two groups.
Results A total of 98 cases of PFO were successfully occluded, among which 2 cases in the TTE group received transesophageal ultrasound guidance due to poor intraoperative sound window. The operation time of the TTE group was significantly longer than that of the X-ray group (P < 0.05). After operation, RLS rating and Headache Impact Test-6 (HIT-6) score of migraine patients in the two groups were significantly lower than those before operation (P < 0.05).
Conclusion Simple TTE guided percutaneous PFO occlusion has a good improvement effect on RLS and migraine in PFO patients, and can avoid radiation damage caused by X-ray to doctors and patients.

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