摘要
目的:总结70岁以上肥厚性梗阻型心肌病(HOCM)患者行经皮室间隔心肌化学消融术(PTSMA)治疗的并发症发生情况及近期疗效,探讨70岁以上HOCM患者行PTSMA的利与弊。方法:对1998-07至2010-07我院行PTSMA治疗的9例70岁以上HOCM患者的临床资料和化学消融结果进行回顾性分析,总结其化学消融术中和术后围术期并发症的发生情况及近期疗效。结果:9例70岁以上HOCM患者中共8例接受PTSMA治疗,术后静息及早搏后左心室流出道压力阶差明显降低(13.29±16.60 vs 77.71±45.51,P=0.006;42.25±21.98 vs 113.50±38.46,P=0.04),左心室射血分数较术前略有下降,但差异无统计学意义(0.60±0.05 vs 0.62±0.05,P=0.053)。术中发生完全性右束支传导阻滞3例,Ⅲ度房室传导阻滞1例,急性心包填塞、死亡1例,急性左心衰竭、死亡1例。结论:70岁以上HOCM患者行PTSMA治疗是有效的,但围术期并发症发生率较高,死亡率较高,因此70岁以上HOCM患者行PTSMA弊大于利,应谨慎施行。
Objective ：To investigate the safety and complication of percutanous transluminal septal myocardial ablation（PTSMA） in aged patients with hypertrophic obstructive cardiomyopathy（HOCM）. Methods：A total of 9 HOCM patients treated by PTSMA in our hospital from 1998 to 2010 were retrospectively studied. The clinical informations, effects and complications of PTSMA during the procedure and at the peri-operative period were summarized. Results：There were 8/9 patients received PTSMA. The left ventricular outflow tract pressure gradient at quiet condition and post premature beat were significantly dropped after the operation （ 13.29 ± 16. 60 vs. 77.71 ±45.51, P = 0. 006 ） and （42. 25± 21.98 vs. 113. 50±38.46,P= 0. 04）. Left ventrieular ejection fraction decreased at certain point,P〉0. 05. There were 3 patients combined with fight bundle branch block, 1 with complete atrioventrieular block and 2 died during the operation. Conclusion： PTSMA was an effective treatment for aged HOCM patients, while the complication rate and the mortality were relatively high.
出处
《中国循环杂志》
CSCD
北大核心
2012年第3期186-188,共3页
Chinese Circulation Journal
关键词
心肌病
肥厚性梗阻型
经皮室间隔心肌化学消融术
并发症
Hypertrophic obstructive cardiomyopathy
Percutaneous transluminal septal myocardial ablation
Complication
作者简介
李成洋副主任医师硕士主要从事心血管病介入治疗Email：ley197606@yahoo．com.cn
通讯作者：李占全Email：LZQLr@medmail．com.cn
