鞘管轨道在Inoue球囊导管进入股静脉中的应用

目的探讨自制鞘管轨道在解决经皮二尖瓣球囊扩张术（PBMV）中Inoue球囊导管沿左心房钢丝进入股静脉困难时的应用,并评价其可行性和安全性。方法 2008年1月至2014年6月在长海医院心内科住院的风湿性二尖瓣狭窄拟行经皮二尖瓣Inoue球囊扩张术的患者共136例,以术中出现Inoue球囊导管沿左心房钢丝进入股静脉困难的18例患者作为研究对象,采用7 F桡动脉血管鞘制作鞘管轨道引导Inoue球囊进入股静脉,观察Inoue球囊导入股静脉的成功率、手术成功率和穿刺处血管并发症。结果在鞘管轨道的辅助下,18例患者均成功将Inoue球囊导入股静脉,手术成功率100%,术后股静脉穿刺处未见静脉撕脱、皮下血肿等并发症发生。结论对于PBMV中Inoue球囊导管沿左心房钢丝进入股静脉困难的患者,使用鞘管轨道能够解决,顺利完成手术并避免穿刺部位出现血管并发症。

The application of sheath orbit in pushing Inoue balloon catheter into the femoral vein

Objective To disscuss a useful technique of self-made sheath orbit to facilitate the delivery of Inoue balloon catheter into the femoral vein through the left atrium wire on percutaneous balloon mitral valvuloplasty and evaluate its feasibility and safety. Methods 136 cases with rheumatic mitral stenosis in Changhai Hospital from January 2008 to June 2014 underwent percutaneous balloon mitral valvuloplasty,of which 18 cases with difficulty in delivery of Inoue balloon catheter into the femoral vein were included as research subjects. Sheath orbit made of 7 F radial artery sheath was used to introduced Inoue balloon catheter into the femoral vein. Its success rate,the operation success rate and vascular complications were observed. Results All 18 cases received successful operations. All the Inoue balloon catheters were smoothly introduced into import femoral vein with the assistance of 7 F sheath orbit. Operation success rate was 100% without postoperative vascular complications. Conclusions When there are difficulty of introducing Inoue balloon catheter into the femoral vein through the left atrium wire in the course of percutaneous balloon mitral valvuloplasty,we can use the sheath orbit to solve puzzles,and to avoid vascular complications.