新生儿心导管术26例分析

Cardiac catheterization in neonates: experience in 26 neonates

摘要:

目的：新生儿心导管术在我国开展很少，该文总结了26例新生儿心导管术,探讨了其特点及在先天性心脏病诊断和治疗中的重要性。方法：新生儿患者26例,年龄5～28d，体重2300～4500g。行右室造影24例,左心系统造影20例；肺静脉楔入造影6例;其中10例行房间隔球囊造口术。结果：诊断紫绀型复杂心血管畸形20例，无紫绀型心血管畸形4例。2例行先天性心脏病术后心内临时起搏器安装。心导管术中非致死性有意义并发症占15.3%,无死亡者。结论：心导管术依然是诊断新生儿复杂心血管畸形最为准确的方法；介入性心导管在新生儿心导管术中将保持重要地位。

Abstract:

Cardiac catheterization is rarely performed in neonates in China. The medical records of 26 neonates who underwent cardiac catheterization in Shanghai Children's Medical Center from June 1994 to June 2004 were reviewed. These infants weighed 2 300 to 4 500 g (mean 3 400±500 g) . Postnatal age ranged from 5 to 28 days (mean 15.2± 8.7 days). Right heart ventricle angiography was performed in 24 cases, left heart ventricle angiography in 20 cases and pulmonary angiography in 6 cases. Balloon aortic septostomy(BAS) was performed in 10 cases. Twenty cases were diagnosed with complex cyanotic cardiovascular malformauions and 4 with acyanotic heart disease. The implantation of a temporary cardiac pacemaker was performed in 2 cases. All diagnostic and interventional procedures were successfully performed. The catheterization-related complications occurred in 15.3% of the 26 cases, but without mortality. In conclusion, cardiac catheterization is an accurate and safe method for diagnosing complex congenital heart diseases in neonates. Interventional catheterization is useful in the treatment of complex congenital heart malformations.