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目的:回顾性分析应用Amplatzer封堵器治疗膜周部室间隔缺损的临床资料,以了解国产Amplatzer封堵器封堵治疗膜周部室间隔缺损的疗效。方法:对84例经超声心动图检查局部解剖结构满足封堵条件的先天性膜周部室间隔缺损患者,在局部麻醉或基础麻醉下行国产Amplatzer封堵器封堵治疗。手术中予以经胸超声心动图和X线监测。封堵成功者进行6~24个月的随访。结果:成功封堵83例(98.8%),1例因术中导引钢丝无法通过室间隔缺损建立轨道,放弃封堵。无死亡。封堵器直径为4~18 mm,1例手术后发生Ⅱ度Ⅱ型房室传导阻滞,2例出现结性心律,经应用肾上腺皮质激素及异丙肾上腺素治疗后好转,3例有少量残余分流,随访过程中无严重并发症出现。结论:在严格掌握指征、规范手术操作方法的前提下,应用国产Amplatzer封堵器封堵膜周部室间隔缺损是一种安全、有效的治疗方法。
OBJECTIVE: To retrospectively analyze the clinical data of Amplatzer occluder for perimembranous ventricular septal defect to understand the curative effect of domestic Amplatzer occluder in the treatment of perimembranous ventricular septal defect. Methods: Eighty-four patients with congenital peritoneal membrane septal defect who underwent occlusion by echocardiography were treated with Amplatzer occluder occlusion under local or basic anesthesia. During operation, transthoracic echocardiography and X-ray were performed. Successful closure of 6 to 24 months follow-up. Results: 83 cases (98.8%) were successfully occluded, and one case failed to establish orbit due to intraoperative guidance of the guide wire, to abandon the occlusion. No death. Occluder diameter of 4 ~ 18 mm, 1 case occurred Ⅱ degree Ⅱ type atrioventricular block, 2 cases of arrhythmia, the application of corticosteroids and isoproterenol improved after treatment, 3 cases with a small amount Residual shunt, no serious complications during follow-up. Conclusion: It is a safe and effective treatment method to block perimembranous ventricular septal defect with domestic Amplatzer occluder on the premise of strictly controlling indications and regulating operation methods.