發(fā)布時(shí)間：2018-04-29 04:25

  本文選題：房間隔缺損 + 介入治療��； 參考：《重慶醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的探討兒童房間隔缺損(atrial septal defect, ASD)封堵器植入前后凝血機(jī)能的變化趨勢(shì)及ASD介入治療的安全、有效性。 方法選取成功接受ASD介入封堵治療的患者19例(女13例,男6例,平均年齡6.74±4.3歲),采用酶聯(lián)免疫吸附法(enzyme linked immunosorbent assays, ELISA)檢測(cè)患者介入封堵前、術(shù)后即刻、術(shù)后1日、術(shù)后30日、術(shù)后90日,血漿凝血酶原片段1+2(prothrombin fragment1+2, F1+2)、p-血小板球蛋白(β-thromboglobulin, β-TG)、血漿組織型纖溶酶原激活物(tissue-type plasminogen activator, t-PA)、D二聚體(D-dimer, D-D)水平,經(jīng)胸超聲心動(dòng)圖(tranthoracic echocardiography, TTE)檢測(cè)是否存在殘余分流、封堵器移位、封堵器血栓。 結(jié)果與封堵術(shù)前比較,F1+2、t-PA、D-D血漿濃度術(shù)后即刻明顯升高,具有統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后1日較術(shù)前水平仍高,但差異無統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后30日基本恢復(fù)至術(shù)前水平；β-TG術(shù)后即刻明顯升高且具有統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后1日基本恢復(fù)至術(shù)前水平；術(shù)后TTE隨訪中未發(fā)現(xiàn)有殘余分流、封堵器移位、封堵器血栓形成。 結(jié)論兒童ASD介入封堵術(shù)后出現(xiàn)了凝血酶、纖溶系統(tǒng)的激活以及血小板的活化,短期內(nèi)恢復(fù)至術(shù)前水平；介入治療ASD安全、有效。 目的探討兒童ASD封堵器植入前后炎癥反應(yīng)程度及相關(guān)因素。 方法選取成功接受ASD介入封堵治療的19例ASD患兒(女13例,男6例,平均年齡6.7±4.3歲),ELISA法檢測(cè)患者介入封堵前、術(shù)后即刻、術(shù)后1日、術(shù)后30日、術(shù)后90日血漿白介素-6(interleukin-6,IL-6)、腫瘤壞死因子-α(tumor necrosis factor-α, TNF-α)濃度,金標(biāo)法測(cè)定C反應(yīng)蛋白(c-reactive protein, CRP)術(shù)前、術(shù)后即刻、術(shù)后1日血漿濃度,比較封堵前后不同時(shí)間點(diǎn)、封堵器大小、介入時(shí)間、封堵器類別、不同性別之間炎癥標(biāo)志物的變化。 結(jié)果與封堵前比較,患兒血漿IL-6、TNF-α濃度術(shù)后即刻升高(P0.05),術(shù)后30日有明顯降低,仍高于術(shù)前但差異無統(tǒng)計(jì)學(xué)意義(P0.05),均于術(shù)后90日基本恢復(fù)至術(shù)前水平；CRP濃度無明顯變化；ASD封堵器直徑≥10mm組與10mm組、手術(shù)時(shí)間≥60min組與60min組、兩不同公司封堵器之間、不同性別之間比較,各組IL-6、TNF-α和CRP水平差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論兒童ASD介入封堵患者體內(nèi)出現(xiàn)一過性炎癥反應(yīng),此炎癥反應(yīng)具有自限性；介入治療ASD安全、有效。
[Abstract]:Objective to investigate the trend of coagulation before and after atrial septal occluder implantation in children with atrial septal defect (ASD) and the safety and efficacy of ASD interventional therapy. Methods A total of 19 patients (female 13, male 6, mean age 6.74 鹵4.3 years old) who were successfully treated with ASD were selected. The patients were detected by enzyme linked immunosorbent assays, ELISA) immediately before, 1 day after operation and 30 days after the operation by enzyme-linked immunosorbent assay (Elisa). Plasma prothrombin fragment 1 2(prothrombin fragment1 2, 尾 -thromboglobulin (尾 -TGG), tissue plasminogen activator tissue type plasminogen activator (t-PAP) D-dimer, D-dimer (D-D) were detected by transthoracic echocardiography (TTEs) on the 90th day after operation, and the residual shunt was detected by transthoracic echocardiography. Occluder shift, occluder thrombus. Results compared with that before occlusion, plasma concentration of F12t PAG D-D increased significantly immediately after operation, and had statistical significance (P 0.05). The level of plasma was still higher on 1 day after operation than that before occlusion. However, the difference was not statistically significant (P 0.05) and recovered to the preoperative level 30 days after operation; 尾 -TG was significantly increased immediately after operation and had statistical significance (P 0.05), and recovered to the preoperative level on 1 day after operation. No residual shunt was found in postoperative TTE follow-up, and occluder displacement was found. Occluder thrombosis. Conclusion Thrombin, fibrinolytic system activation and platelet activation after interventional closure of ASD in children recovered to preoperative level in a short time, and interventional therapy for ASD was safe and effective. Objective to investigate the degree of inflammatory reaction and related factors before and after ASD occluder implantation in children. Methods A total of 19 patients (13 female, 6 male, mean age 6.7 鹵4.3 years) with ASD received successful interventional closure of ASD were detected by Elisa before, immediately, 1 day, 30 days after the operation. Plasma levels of interleukin-6 (IL-6) and tumor necrosis factor- 偽 (TNF- 偽) were measured 90 days after operation. Plasma concentrations of C-reactive protein (CRP) were measured by gold standard method before, immediately after operation and 1 day after operation. The size of occluder and interventional time before and after occlusion were compared. Type of occluder, changes in inflammatory markers between genders. Results compared with that before occlusion, plasma IL-6 TNF- 偽 concentration increased immediately after operation and decreased significantly 30 days after operation. It was still higher than that before operation, but the difference was not statistically significant (P 0.05). There was no significant change in the concentration of CRP to the preoperative level 90 days after operation. The diameter of ASD occluder 鈮，

本文編號(hào)：1818383