116例卵圆孔未闭患者行介入封堵治疗的近期疗效观察
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南京医科大学第一附属医院

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国家自然科学基金青年科学基金项目(81800313)、江苏省人民医院临床能力提升工程(JSPH-MB-2020-7)


Short-term efficacy and safety of interventional occlusion in the treatment of patent foramen ovale
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    摘要:

    目的:评价介入封堵治疗卵圆孔未闭伴神经系统症状患者的近期疗效和安全性。方法:本研究为回顾性研究。入选2019年2月~2021年1月于南京医科大学第一附属医院神经内科诊断为隐源性卒中/短暂性脑缺血发作或偏头痛,经颅多普勒超声发泡实验(contrast-enhanced transcranial doppler, c-TCD)筛查III~IV级右向左分流且在我院心血管内科确诊卵圆孔未闭并行介入封堵的患者116例,随访观察介入封堵成功率、术后分流情况、术后脑卒中及头痛事件以及并发症情况。结果:本组患者封堵成功率为97.4%,随访期内无封堵器移位、心包积液、新发心律失常等并发症。经颅多普勒结果证实术后3天,75.2%(85/113)患者分流量有不同程度的减小。偏头痛症状患者术后6个月头痛影响测试-6(HIT-6)评分显著低于术前(P<0.001),随访期内无影像学提示的新发卒中。结论:卵圆孔未闭伴隐神经系统症状患者行介入封堵治疗成功率高且安全;术后脑卒中及偏头痛等神经系统事件明显减少,疗效肯定。

    Abstract:

    Objective: To evaluate the short-term efficacy and safety of interventional occlusion in the treatment of patent foramen ovale. Methods: This retrospective study enrolled 116 migraine or cryptogenic stroke patients from Department of neurology, the first affiliated hospital of Nanjing medical university from February 2019 to January 2021, in which level III ~ IV right-to-left shunt was screened out by contrast-enhanced transcranial doppler. These patients were finally diagnosed with patent foramen ovale and received interventional closure in Department of cardiovascular. We carried out regular follow-up of post-closure by clinics and telephones. Results: The success rate of closure was 97.4%. During the follow-up period, there were no severe complications such as occluder displacement, pericardial effusion and new arrhythmia. Transcranial doppler confirmed that the right-to-left shunt volume of 75.2% (85/113) patients decreased after surgery. The HIT-6 scores of migraine patients at 6 months after surgery were significantly lower than those before surgery (P < 0.001), and there was no new stroke in the follow-up period. Conclusion: Recent follow-up shows that the closure of patent foramen ovale is an effective and safe therapy for patent foramen ovale patients with migraine and cryptogenic stroke.

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  • 收稿日期:2021-03-09
  • 最后修改日期:2021-05-07
  • 录用日期:2021-09-28
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