原发性肝癌患者行超声引导下经皮微波消融术后相关并发症的发生情况

目的探讨超声引导下原发性肝癌(PHC)经皮微波消融术(PMCT)相关严重并发症的原因及防治对策。方法选取2012年1月-2014年12月中国人民解放军空军总医院肝胆外科收治的PHC患者652例,均在超声引导下行PMCT。观察患者PMCT术后相关并发症的发生情况,并比较2012、2013和2014年并发症发生的差异,总结防治对策。计数资料组间比较采用χ2检验。结果共18例患者出现PMCT相关严重并发症,发生率为2.76%,其中包括腹腔出血10例,肝脓肿2例,肠瘘1例,膈肌破裂2例,急性肾衰竭1例,肿瘤种植转移1例,心脑血管疾病1例;因并发症死亡1例,并发症相关病死率为5.56%(1/18);2012、2013和2014年PMCT相关并发症发生情况差异有统计学意义(χ2=11.78,P=0.003)。结论超声引导下PMCT总体上是安全的,但对于肝肿瘤部位特殊、肝硬化程度重、合并其他系统疾病者风险仍较大,严格掌握手术适应证,加强术前预防性治疗、术中规范性操作、术后严密观察患者病情变化能够显著降低PMCT并发症带来的不良后果。     

腹腔镜肝切除术在肝癌合并肝硬化患者的应用

目的：探讨腹腔镜下肝切除（LH）与开腹肝切除（OH）在治疗肝癌合并肝硬化患者近期疗效之间的差别。方法选取2010年9月至2012年6月武汉大学人民医院住院的肝癌合并肝硬化患者78例,分为2组,其中LH组32例,OH组46例,分析比较2组术中、术后恢复以及术后复发之间的差别。计量资料采用成组t检验和配对t检验,计数资料采用χ2检验。结果2组比较,术中失血量,LH组显著低于OH组（t＝0．057,P＝0．040）;手术时间,LH组高于OH组（t＝3．101,P＝0．003）;术后并发症方面,电解质紊乱、胆漏、腹水,LH组显著低于OH组（t＝3．001,3．241,4．255,P均＜0．05）;术后第1天肝功能水平（AST、ALT）,LH组显著低于OH组（t＝3．427、3．201,P＝0．001、0．002）;术后开始经口摄食的时间,LH组显著短于OH组（t＝3．012,P＝0．001）;住院时间LH组显著低于OH组（t＝2．157,P＝0．003）;肿瘤复发方面,LH组显著少于OH组（t＝2．751,P＝0．006）。结论对于肝癌合并肝硬化患者,LH较OH,无论在手术切口、术中失血量、术后腹水发生率、术后并发症、住院时间以及术后肿瘤的复发的发生方面都具有显著优势。     

提高原发性肝癌肝切除手术安全性的临床研究

目的探讨提高原发性肝癌（pfimau hepatic carcinoma,PHC）肝切除手术安全性的有效途径。方法回顾性分析403例PHC患者的临床资料,其中250例采用解剖性分离方法（A组）进行肝切除;153例采用传统钳夹法（B组）进行肝切除。比较2组术中出血及输血情况、术后肝功能、并发症发生率、手术死亡率及住院时间。结果A组肿瘤直径为（7．13±4．57）am,术中出血量为（438±225）ml,输血44例（17．6％）,输血量为（510±290）ml,无手术死亡及腹腔出血、肝衰竭等严重并发症,轻度并发症14例（5．6％）,术后住院时间为（11．3±5．1）d。B组肿瘤直径为（5．97±3．23）cm,术中出血量为（1200±360）ml,输血51例（33．3％）,输血量为（1440±663）ml,发生并发症42例（27．5％）,其中术后腹腔出血7例、肝衰竭6例,手术后30d内死亡7例（4．58％）,术后住院时间为（19．1±9．7）d。A组术中出血量、输血量、手术死亡率、术后严重并发症发生率、总并发症发生率、术后住院时间均低于B组（P〈0．05）。结论在积极的围手术期处理同时,采用解剖性分离法进行肝切除,可以显著提高PHC肝切除手术安全性。     

经皮微波治疗肝癌坏死范围的超声判断

目的探讨在超声引导下经皮微波凝固（PMCT）术治疗肝癌过程中采用实时灰阶超声判断凝固坏死范围的价值。方法在PMCT术治疗19例HCC患者过程中,采用灰阶超声全程监测治疗灶强回声范围的最大短轴径（SDT）和最大长轴径（LDn在治疗后1小时和1个月后,再次行实时灰阶谐波超声造影测量凝固坏死灶对应的SDc和LDc。结果在18例治疗灶明显增强的患者,治疗时病灶表现出椭圆状强回声,其SDT与1小时后超声造影的SDC1的相关系数为0．64,LDT与LDCI的相关系数为0．73;SDT与一月后超声造影SDC2的相关系数为0．79;LDT与LDC2的相关系数为0．76。1例患者术中治疗灶强回声范围表现不明显,超声造影证实为完全坏死。结论在PMCT术中灰阶超声监测的病灶最大强回声范围与术后超声造影所测凝固坏死灶大小具有一定的相关性,可作为治疗时凝固坏死范围的参考;但因它们的相关系数并不高,且有个别病灶强回声表现不明显,故在PMCT术后还应采用多种监测手段综合判断其疗效。     

超声引导经皮射频消融对邻近横膈部原发性肝癌治疗的有效性与安全性评价

目的探讨超声引导下经皮射频消融治疗邻近横膈部原发性肝癌的安全性及有效性。方法收集2011年1月至2014年10月解放军三○二医院行超声引导经皮射频消融治疗的患者277例,共计362个原发性肝癌病灶,根据入组标准选择其中66例(共71个邻近横膈部病灶)作为研究组,95例(共114个位于肝实质病灶)作为对照组。比较两组患者病灶治疗术后肿瘤灭活率、局部肿瘤进展发生率和并发症发生情况。计量资料两组间比较采用独立样本t检验,计数资料两组间比较采用χ2检验。结果术后1个月,增强CT或磁共振成像显示研究组65个病灶(91.5%)及对照组107个病灶(93.9%)完全灭活,两组比较差异无统计学意义(χ2=0.36,P=0.55);随访术后研究组与对照组发生局部肿瘤进展的病灶分别为16.9%、13.2%,两组比较差异无统计学意义(χ2=0.49,P=0.48)。研究组术后有22例患者出现副反应,对照组有37例患者出现副反应,两组比较差异无统计学意义(χ2=2.60,P=0.11)。结论超声引导经皮射频消融治疗膈顶部肝肿瘤是安全、有效的。     

肝肿瘤联合脾切除术治疗原发性肝癌合并脾功能亢进

目的探讨肝肿瘤联合脾切除术治疗原发性肝癌（PHC）合并脾功能亢进的效果及可行性。方法将60例PHC合并脾功能亢进患者分为联合组及对照组各30例,分别行肝肿瘤联合脾切除术及单纯肝肿瘤切除术。观察两组术中出血量、术后并发症（消化道出血、感染、腹水、黄疸等）发生情况;术后4周复查血常规、肝功能、免疫功能。结果两组术中出血量、术后并发症发生率均无显著差异,手术前后肝功能均无显著变化;联合组外周血WBC和PLT均显著高于术前及对照组（P〈0．05）,两组术后CD3、CD4、CD4／CD8及及NK均显著高于术前（P〈0．05）,且联合组升高趋势更明显。结论对PHC并脾功能亢进患者行一期肿瘤联合脾切除术可促进外周血WBC和PLT恢复正常,改善患者免疫机能,且不增加手术风险。     

TACE治疗原发性肝癌267例疗效观察及影响因素分析

目的探讨超选择肝动脉灌注化疗栓塞术（TACE）治疗原发性肝癌（PHC）的效果及预后相关因素。方法对267例PHC患者在综合治疗基础上行超选择TACE,随访4a观察生存情况及预后相关因素。结果本组1、2、3、4a生存者分别为126、89、44、8例;肿瘤多发、直径〉10cm及Ⅳb期患者3、4a生存率显著低于肿瘤单发、直径〈10cm及Ⅲ期、Ⅳa期患者（P〈0．05）。结论超选择TACE治疗PHC能延长患者生存期;肿瘤临床分期、直径及数量对预后影响明显。     

经皮肝穿刺胆道腔内射频消融联合胆道支架治疗恶性胆道梗阻的临床观察

目的：探讨经皮肝穿刺胆道腔内射频消融技术姑息性治疗恶性梗阻性黄疸的安全性及可行性。方法选取2013年1月－2014年3月接受治疗的20例无法切除的恶性梗阻性黄疸患者作为实验组,其中9例不能外科手术切除患者透视下行经皮肝穿刺胆道腔内射频消融术,并留置金属胆道支架;同期随机纳入11例相似病情患者作为对照组,经皮肝穿刺胆道造影（PTC）成功后仅行胆道支架置入。观察两组手术并发症及黄疸缓解情况,密切随访并比较术后3和6个月支架的通畅性。结果所有患者术后通过门诊或电话均获得完整随访。实验组及对照组术后3个月支架通畅率分别为100％,72．7％（χ2＝2．888,P ＝0．218）,术后6个月支架通畅率分别为：87．5％、27．3％（χ2＝6．739,P ＝0．02）。随访期内射频组1例患者于术后113 d 死于消化道出血,对照组1例患者于57 d 死于肝功能衰竭,1例患者于术后142 d 死于弥散性血管内凝血。结论经皮肝穿刺胆道腔内射频消融对恶性胆道梗阻的治疗是安全和可行的,在延长自膨式金属支架通畅性方面初步疗效令人满意,但尚需大量样本随机对照研究进一步验证。     

超声引导经皮微波固化治疗肝癌的临床应用

探讨肝癌患者经超声引导进行微波凝固治疗的方法及临床应用价值。超声引导经皮微波固化治疗(PMCT)患者24例,共32个结节,PMCT治疗后用超声监测结节的变化。术后2个月结节开始逐渐缩小,25个结节明显缩小,5个结节变化不明显,2个结节可见血流进入病灶。PMCT是目前灭活率最高的肿瘤物理疗法,是一种应该发展普及的治疗肝癌新手段。     

超声导引下经皮微波消融治疗邻近危险区域肝癌临床观察

目的探讨经皮微波消融（PMCT）治疗邻近胃肠、胆囊、膈肌、心脏、肾脏等危险区域（即肿瘤距上述脏器最短距离≤0.5 cm）肝癌的有效性和安全性,寻找合适的治疗条件,从而实现对肝脏肿瘤完全凝固坏死而邻近重要器官无明显热损伤。方法选择邻近胃肠（4例）、胆囊（10例）、膈肌（24例）、心脏（4例）、肾脏（3例）等危险区域肝癌患者45例均行PMCT治疗。术前术后均行B超,增强CT扫描,检测甲胎蛋白（AFP）,判断疗效。同时常规查肝肾功能。观察不良反应及并发症的发生率,血清AFP变化,肿瘤缓解率。结果⑴PMCT后8周增强CT提示肿瘤完全坏死38例,坏死率84.44%;4周复查AFP,35例AFP术前阳性患者中23例转为阴性（65.71%）,与文献报道非危险区域肝癌微波消融治疗的疗效无差异。⑵1例邻近膈顶肝癌患者PMCT治疗后出现血胸,经止血对症治疗7 d后出血吸收出院;1例出现针尖断开滞留于消融中心区域,无症状,随访一年针尖位置无变化。其余患者均未出现与操作相关并发症。结论采取适当措施下对于邻近危险区域肝癌进行PMCT治疗,其疗效与非危险区域PMCT疗效接近,同时可以避免出现与操作相关的并发症。     

枯草杆菌二联活菌肠溶胶囊防治经肝动脉化疗栓塞术后不良反应及并发症的效果评价

目的探讨枯草杆菌二联活菌肠溶胶囊对经肝动脉化疗栓塞术(TACE)术后不良反应及并发症的防治作用。方法选取2012年1月-2013年12月大连大学附属中山医院收治的择期进行TACE的肝细胞癌患者239例,随机分为试验组(n=111)与对照组(n=128)。其中试验组于术前3 d给予口服枯草杆菌二联活菌肠溶胶囊,对照组服用外形相同的安慰剂,比较2组TACE术后不良反应、并发症发生率及血氨水平。计量资料组间比较采用独立样本t检验,计数资料组间比较采用χ2检验。结果试验组患者发热、腹胀、便秘等不良反应发生率显著低于对照组,差异均有统计学意义(t值分别为2.728、2.561、2.026,P值均0.05);试验组患者肝脓肿、肠梗阻、自发性腹膜炎、肝性脑病等术后并发症的发生率亦显著低于对照组,差异均有统计学意义(t值分别为1.969、2.312、2.987、2.826,P值均0.05);经治疗后,与对照组相比,试验组患者血氨水平较低,差异具有统计学意义(t=1.97,P0.05)。结论枯草杆菌二联活菌肠溶胶囊作为新型活菌制剂,能够降低TACE术后患者腹部不适及血氨水平,并能够减少肝脓肿等严重并发症的发生,但相关机制尚需进一步研究。     

Radiofrequency ablation versus percutaneous microwave coagulation therapy for small hepatocellular carcinomas: a retrospective comparative study

BACKGROUND/AIMS: Although local ablation procedures are useful in eradication treatment for small hepatocellular carcinoma (HCC), there have only been a few clinical studies comparing the response to radiofrequency ablation (RFA) and percutaneous microwave coagulation therapy (PMCT). We evaluated the clinical effect and safety of these two procedures for the treatment of small HCCs measuring 2cm or less in diameter. METHODOLOGY: Twenty-four patients with HCC who were treated by RFA and were compared with 39 patients with HCC who underwent PMCT. These procedures were repeated until complete tumor necrosis was achieved. The therapeutic and adverse effects were retrospectively compared between the two procedures. RESULTS: (1) There were significantly fewer treatment sessions (P < 0.001) in the RFA group than the PMCT group, and the necrotic area was significantly larger (P < 0.001) in the former group. (2) The local recurrence rate was significantly lower (P = 0.012) after RFA than after PMCT, even though the ectopic recurrence rate showed no significant difference. 3) The cumulative survival rate was significantly higher (P = 0.028) in the RFA group. (4) The incidence of pain and fever after treatment was significantly higher after PMCT than after RFA. Bile duct injury and pleural effusion were also more frequent in the PMCT group. CONCLUSIONS: RFA is more useful than PMCT in the treatment of small HCCs because it is minimally invasive and achieves a low local recurrence rate, high survival rate, and extensive necrosis after only a few treatment sessions.     

Comparison of therapeutic effects between radiofrequency ablation and percutaneous microwave coagulation therapy for small hepatocellular carcinomas

Background:  Although thermal ablation therapies have gained fairly wide acceptance as an effective treatment for small hepatocellular carcinoma (HCC), there have been only a few clinical studies comparing the response to radiofrequency ablation (RFA) and percutaneous microwave coagulation therapy (PMCT). We evaluated the therapeutic efficacy and safety of these two procedures for the treatment of small HCC measuring ≤ 2 cm in diameter.
Methods:  Thirty-four patients who had 37 nodules were treated by RFA and were compared with 49 patients (56 nodules) who underwent PMCT. Treatment was repeated until complete tumor necrosis was confirmed by contrast computed tomography (CT) scanning. The therapeutic efficacy and complications were retrospectively compared between the two procedures.
Results:  (i) There were significantly fewer treatment sessions ( P  < 0.001) in the RFA group than in the PMCT group, but the necrotic area was significantly larger ( P  < 0.001) in the former group. (ii) The local recurrence rate was significantly lower ( P  = 0.031) after RFA than after PMCT, although the ectopic recurrence rate showed no significant difference. (iii) The cumulative survival rate was significantly higher ( P  = 0.018) after RFA than after PMCT. (iv) The incidence of pain and fever after treatment was significantly higher in the PMCT group. Bile duct injury, pleural effusion, and ascites were also significantly more common in the PMCT group.
Conclusions:  RFA is more useful than PMCT for the treatment of small HCC because it is minimally invasive and achieves a low local recurrence rate, high survival rate, and extensive necrosis after only a few treatment sessions.     

Successfully Managed Access-Site Complication Was Not Associated With Worse Outcome After Percutaneous Transfemoral Transcatheter Aortic Valve Implantation: Up-to-Date Insights From the OCEAN-TAVI Registry

BackgroundAccess-site complications during transfemoral transcatheter aortic valve implantation (TF-TAVI) cause serious issues in the future, if unresolved, but the best strategies to manage these complications remains unclear. This study aimed to comprehensively assess access-site complications during percutaneous TF-TAVI in terms of their management.MethodsUsing the prospective, multicentre, observational registry OCEAN (Optimized Transcatheter Valvular Intervention), 1497 patients who underwent percutaneous TF-TAVI between October 2013 and May 2017 were identified. The incidence, predictors, temporal changes, and prognosis of access-site complications along with its treatment strategy and re-intervention rate were evaluated.ResultsAccess-site complications occurred in 105 patients (7.0%) and was predicted with lower body-mass-index (OR, 0.94; 95% CI; 0.89–0.99; p = 0.03) and higher sheath-to-femoral-artery-ratio (OR, 1.12; 95% CI, 1.03–1.24; p < 0.002). The incidence of access-site complications declined over time, irrespective of the increasing number of percutaneous TF-TAVI cases. Access-site complications were treated by conservative therapy (n = 19, 18%), interventional procedures (n = 42, 40%), rescue surgical repair (SR) (n = 10, 10%), and primary SR (n = 34, 32%). The severity of complications differed but the re-intervention rate was similar among 4 groups (p = 0.46). Re-intervention was not needed, except for a case of common femoral artery stenosis/occlusion induced by ProGlide. The need for all SRs decreased annually. Access-site complications were not associated with 30 days- and 1 year-survival rate.ConclusionsThe incidence of access-site complications was not low but has declined annually. Access-site complications are not related to worse outcomes after successful management. Interventional procedure is acceptable as the first-line strategy to treat access-site complications.     

Treatment of solitary small hepatocellular carcinoma: consideration of hepatic functional reserve and mode of recurrence

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) recurs frequently after initial treatment. The subsequent prognosis varies with the mode of recurrence. Some patients die of hepatic failure even though the HCC is controlled. We consider the clinical stage (CS), using the modified Child-Pugh classification, to be an important factor influencing the prognosis of these patients. METHODOLOGY: To determine the most effective treatment for HCC, we examined 105 patients with solitary small HCC who were followed-up for more than 1 year after initial treatment. All of them were judged to be cured according to imaging or histological studies. The initial treatments were hepatic resection (n = 43), percutaneous ethanol injection therapy (PEIT, n = 33), and percutaneous microwave coagulation therapy (PMCT, n = 29). The modes of recurrence were divided into intrahepatic metastasis (IM) and multicentric occurrence (MO). RESULTS: Prognosis of MO was superior to that of IM in CS I patients, but there was no difference in prognosis between these modes in CS II. The hepatic resection group had more MO recurrences in CS I patients and more IM recurrences in CS II patients. IM developed frequently after PEIT and PMCT, regardless of the CS. Prognosis with hepatic resection was superior to that of the other treatments in CS I patients, but there was no difference in prognosis among the 3 treatment modalities in CS II patients. CONCLUSIONS: These data indicate that hepatic resection is the first choice for treating HCC in CS I patients, and that PEIT or PMCT is preferable for CS II patients.     

Thermal ablation therapy for hepatocellular carcinoma: comparison between radiofrequency ablation and percutaneous microwave coagulation therapy

BACKGROUND/AIMS: To evaluate the initial therapeutic effect and safety of radiofrequency ablation (RFA) and percutaneous microwave coagulation therapy (PMCT) for the treatment of small hepatocellular carcinomas (HCCs). METHODOLOGY: Forty-eight patients with HCC were treated by RFA and 70 patients with HCC were treated by PMCT. These procedures were repeated until complete tumor necrosis was confirmed by contrast CT scanning. The therapeutic and adverse effects were compared between the two procedures. RESULTS: 1) The number of treatment sessions was significantly lower in RFA patients, and the necrotic area was significantly larger. 2) The local recurrence rate was significantly lower after RFA than after PMCT, while the ectopic recurrence rate showed no significant difference between the two procedures. 3) The survival rate was significantly higher after RFA compared with PMCT. 4) The incidence of pain and fever after treatment was significantly higher in PMCT patients. Occurrence of bile duct injury, pleural effusion and ascites were also significantly more common in PMCT patients. CONCLUSIONS: RFA is more useful for the treatment of small HCCs compared with PMCT because it is minimally invasive and achieves a low local recurrence rate, a high survival rate, and extensive necrosis after only a few treatment sessions.     

Vascular complications of infective endocarditis: a retrospective analysis of 18 cases

OBJECTIVES: Among 82 patients hospitalized for infective endocarditis between June 1995 and June 2001 at the cardiology B unit of the Rabat University Hospital Morocco, 18 (22%) had one or more vascular complications. We present here a retrospective analysis. PATIENTS AND METHODS: The cohort included 12 men and 6 women, mean age 22 years. Infective endocarditis had grafted on a pre-existing cardiopathy among 17 patients: rheumatic heart disease (n=14), mechanical prosthetic valve (n=2), congenital heart disease (n=1). RESULTS: For 12 patients, vascular disease was the only complication, 1 had two complications and 4 three complications. This gave 26 lesions: 11 neurological complications, 10 arterial diseases involving the limbs including 5 mycotic aneurysms, 2 acute myocardial infarcts, 2 splenic infarcts, and 1 recurrent septic pulmonary embolism. Vascular disease was the inaugural manifestation in 9 patients and 54% of the complications occurred before the end of the second week of antibiotic treatment. Blood cultures were positive in 7 patients (40%). Oral streptococcus was isolated in 5 cases, Gram-negative bacillus in 1 case and Staphylococcus aureus in 1. Echography revealed valvular vegetations in the 16 cases of infective endocarditis on native valves: mitral (n=9), aortic (n=5), mitroaortic (n=1), tricuspid (n=1). Short term outcome was marked by 4 deaths including 3 directly related to the vascular complication. DISCUSSION: We emphasize the variable and diverse features of vascular complications of infective endocarditis. Prevention and early diagnosis are essential to institute optimal management of infective endocarditis.     

Do corticosteroids add any benefit to standard GVHD prophylaxis in allogeneic BMT?

In a retrospective study, we compared 15 patients who received cyclosporine (CsA), methotrexate (MTX) and prednisone (PDN) and 15 patients who received CsA-MTX for GVHD prophylaxis after allogeneic BMT (HLA-identical sibling (n = 22), related one HLA mismatch (n = 1), unrelated matched donors (n = 6), unrelated one HLA mismatch (n = 1)). The primary objectives of this study were to compare the incidence of GVHD and post-transplantation complications. Secondary objectives were to compare relapse rate, transplant-related mortality and overall survival. The incidence of acute GVHD grade III-IV was similar between the two groups (P = 0.66), as was the incidence of chronic GVHD (P = 0.67). Incidence of arterial hypertension was significantly higher in patients who received prophylactic PDN, (P = 0.03) and more insulin treatment was required in this group (P = 0.003). We observed no differences in the incidence of infections or upper digestive tract bleeding. Musculoskeletal complications appeared earlier in the group which received PDN. With a median follow-up of 4.4 years, patients in the CsA-MTX group had better overall survival, 46.7% vs 13.3% (P = 0.026). Relapse was a more frequent cause of death in the CsA-MTX group, whereas procedure-related mortality was more frequent in the CsA-MTX-PDN group (P = 0.013). These results suggest that prophylactic prednisone when combined with cyclosporine and methotrexate adds no benefit in acute or chronic GVHD prevention and may increase the morbidity of allogeneic transplantation. Corticosteroids may be reserved for GVHD treatment.     

Simultaneous kissing stents (SKS) technique for treating bifurcation lesions in medium-to-large size coronary arteries

The treatment of bifurcation lesions (BLs) is associated with high procedural complication and restenosis rates. Two techniques of BL interventions were compared: the simultaneous kissing stents (SKS) technique, involving 2 stents, 1 in the main vessel and 1 in the side branch (n = 100), and the conventional stent strategy (CSS) technique, involving a stent in the main vessel and provisional stenting for the side branch (n = 100). In-hospital and 30-day major adverse cardiac events were greater in the CSS group, with significantly less procedure time with the SKS technique. The incidence of target lesion revascularization was 5% in the SKS group and 18% in the CSS group (p = 0.007). Therefore, the SKS technique seems to be rapid, safe, and effective for the treatment of medium- to large-size BLs, with a trend toward fewer acute complications and promising mid-term results.     

2005至2006年全军结构性心脏病介入治疗现状分析

目的 总结全军38所医院2005年1月至2006年12月开展结构性心脏病介入治疗的疾病、数量及出现的并发症,为今后开展此类手术提供指导和借鉴.方法 通过统一问卷收集全军各医院2005年1月至2006年12月介入治疗结构性心脏病的病例资料统计表,包括实施介入治疗的病例数量、成功例数以及各种介入治疗出现的并发症,然后进行数据统计学分析.结果 共收回38所医院资料统计表.2年期间共进行介入治疗8862例,成功8692例,成功率98.08%.其中室间隔缺损(VSD)、房间隔缺损(ASD)、动脉导管未闭(PDA)、二尖瓣狭窄(MS)和肺动脉瓣狭窄(PS)5种疾病介入治疗8684例,占介入治疗总数的97.99%,而其他少见心脏畸形的介入治疗仅占2.01%.在所有封堵术治疗中,进口封堵器使用率仅占8.77%,而国产封堵器使用率高达91.23%.共出现并发症384例,并发症发生率4.33%,其中VSD并发症发生率最高,达9.72%,占全部并发症的84.38%.所有并发症中最常见者为各种传导阻滞(260例),其次是残余分流(42例),封堵器脱落(30例)和三尖瓣关闭不全(22例).相对于2003至2004年,介入治疗病例增长57.32%,成功率略有降低,并发症发生率也呈现降低趋势.结论 随着介入治疗经验的成熟,介入治疗成为治疗结构性心脏病安全有效的方法.部分并发症需要长期随访才能发现,如何做好介入治疗后的长期随访是今后的重点.