临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (10): 956-.doi: 10.3969 j.issn.1000-3606.2014.10.015

• 综合报道 • 上一篇    下一篇

儿童常见先天性心脏病介入治疗的并发症分析

庞程程,张智伟,钱明阳,李渝芬   

  1. 广东省心血管病研究所 广东省人民医院心儿科(广东广州 510080)
  • 收稿日期:2014-10-15 出版日期:2014-10-15 发布日期:2014-10-15
  • 通讯作者: 张智伟 E-mail:drzhangzhiwei@sina.com

Analysis of complications during and post to interventional therapy of common congenital heart disease in children

 PANG Chengcheng, ZHANG Zhiwei, QIAN Mingyang, LI Yufen   

  1. Department of Cardiology, Cardiovascular Institute of Gruangdong Province, Guangdong General Hospital, Guangzhou 510080, Guangdong, China
  • Received:2014-10-15 Online:2014-10-15 Published:2014-10-15

摘要: 目的 总结儿童先天性心脏病(CHD)介入治疗并发症的发生率,并分析其发生原因。方法 回顾性分析2011年1月至2013年12月间2 356例诊断为室间隔缺损(VSD)、房间隔缺损(ASD)、动脉导管未闭(PDA)、肺动脉瓣狭窄(PS),并行介入治疗的0~18岁CHD患儿,在介入治疗中及治疗后发生并发症的情况。结果 2 356例CHD患儿中159例发生并发症,发生率为6.75%;其中VSD组为11.40%(82/719),ASD组为7.50%(51/680),PDA组为3.09%(22/712),PS组为1.63%(4/245)。心律失常发生率为4.41%(102/2 356)。严重并发症发生率为2.71%(64/2 356),VSD组为3.62%(26/719),ASD组为2.21%(15/680),PDA组为2.53%(18/712),PS组为1.63%(4/245);术中严重并发症为0.51%(12/ 2 356),术后早发严重并发症为1.99%(47/2 356),迟发严重并发症为0.21%(5/2 356)。严重并发症经介入手术治疗0.13% (3/2 356),经外科手术治疗0.64% (15/2 356),经内科保守治疗1.95%(46/2 356);2例死亡,死亡率0.08%。结论 CHD介入治疗的并发症及死亡率低,但仍不容忽视。术前严格掌握适应证,术中按常规操作,术后进行规范的长期随访至关重要。

Abstract: Objective To analyze the incidence of complications during and after interventional therapy for common congenital heart disease (CHD) in children. Methods From January 2011 to December 2013, interventional therapy of common congenital heart disease which include ventricular septal defect (VSD), atrial septal defect (ASD), patent ductus arteriosus (PDA) and pulmonary valve stenosis (PS) were performed in 2356 patients. Among them, 159 patients who developed complications during and post to interventional therapy were retrospectively analyzed. Results The overall complication rate was 6.75% (159/2356) (11.40% post VSD occlusion, 7.50% post ASD occlusion, 3.09% post PDA occlusion, 1.63% post percutaneous balloon pulmonary valvuloplasty (PBPV) ).The rate of arrhythmia was 4.41%(102/2356). The severe complication rate was 2.71% (64/2356) (3.62% post VSD occlusion, 2.21% post ASD occlusion, 2.53% post PDA occlusion, 1.63% post PBPV). The intraoperative severe complication rate was 0.51%(12/2356); the early severe complication rate was 1.99% (47/2356); the late severe complication rate was 0.21% (5/2356). Interventional therapy rate was 0.13% (3/2356); cardiovascular surgery rate was 0.64% (15/2356); conservative treatment rate was 1.95%(46/2356). The mortality rate was 0.08% (2/2356). Conclusions The complications and mortality rate of interventional therapy for CHD in children are relatively low, but cannot be ignored. The complication could be reduced by choosing proper indications, following the operational procedures and careful operative follow-up.