【Summary 】 purpose:Study to through the chest super voice the function which move diagram(TTE) instruction room to separate defection and damage(ASD) to seal to block up Shu.Method:30 after hair bore type ASD sufferer Shu be ex- to all adopt much more colorful Pu Lei TTE to add the nature organization Xie wave function to measure through the chest each slice noodles ASD size, the monitor seals to block up process, seal firm and much more colorful observation of Pu Lei of block up the machine have already had no remnants remaining reposition of redundant personnel.Seal to block up a machine after release measure its loins size combine with measure biggest path of ASD a comparison before the Shu.Result:Used TTE to check the biggest path of ASD as the 7 mm ～ 30 mms(average 18.5 mms) before the Shu, chose to use to seal to block up the machine 10 mm ～ 38 mms(average 24 mms), sealed to block up the machine waist path 7 mm ～ 30 mms after release.(average 18.5 mms)The TTE measures ASD size and seals to block up machine size related and good.In addition to a block up a machine to move to change to through the chest surgical operation, the rest sufferer seals to block up a machine to fix firm, shed off.Conclusion:The TTE can be more accurate to measure ASD size, is guide ASD to seal to block up of go of valid method.
【Keyword 】 Be moved diagram by the chest super voice;The room separates defection and damage;Seal to block up Shu
The room of congenital heart attack separates defection and damage(ASD) since go toward adoption surgery to open chest surgical operation a repair.Several near in the last yearses, along with get involved the development of medical science, wear to stab to place person AmPLatzer to seal to block up a machine to get involved a treatment through the skin after hair bore ASD, have become a kind of safety effectively, tiny create, recover quick method ［ 1~5 ］s.My hospital measuresed ASD before the Shu in the TTE to January, 2007 in June, 2003 and the monitor sealed to block up a machine and positioned 30 and a blocked up a machine to move to change to surgery to open chest surgical operation, besides which, ， the rest all obtained good effect, Be report as follows now.
One data and method
1.1 research objects
Sufferer’s 30(male 9, female 21), the age 5-year-old ～ is 61 years old, the average ge is 33 years old, all sufferers through clinical, X line, TTE diagnosis is after hair bore type ASD.
1.2 instruments and method
1.2.1 instruments
Use the HD11 of Philps , uncommon and type HDI-3500 much more colorful Pu Lei super voice diagnosis instrument, stretch forward a frequency 1 MHz ～ 3 MHzs, the 2 MHz ～ 4 MHzs and 2.5 MHzs, check to all add the nature organization Xie wave function before the Shu, in order to clear show an ASD week, good luck soft hard degree and length.
1.2.2 check a method and seal a choice of block up the machine model number before the Shus
Seal to block up before the Shu all sufferers all go much more colorful Pu Lei a super voice a check and the TTE checks in common use following to slice noodles:Breastbone side four chambers slice noodles, greatly afferent minor axis to slice noodles, the sword next two chamberses to slice the noodles, sword next and last chamber vein and descend chamber vein major axis to slice noodles.Point measure ASD front next empress last path, in front and back path and top and bottom path;The room separates distance of is apart from the left house roof department, be apart from the distance of aorta wall and be apart from up the chamber vein and descend the distance of chamber vein and be apart from two sharp the distance of leaf’s root before the petal.Be apart from the distance choice of peripheral each good luck to block up a machine model number to carry on sealing than the seal of ASD the biggest path big 2 mm ～ 8 mms according to the ASD size and the ASD.Use of seal to block up the machine as Shenzhen first Jian science and technology incorporated company of the ASD seal to block up a machine.
It monitors in 1.2.3 Shus
In the Shu adopt breastbone side four chambers slice noodles and greatly afferent minor axis to slice noodles solid hour observe instruction, observe first to seal to block up whether the machine left building side is located on left building to run parallel with or looks like to run parallel with room to separate or not, gradual behind withdraw a sheath tube to make a left building side umbrella to come close room to separate, observe in the TTE under release to seal loins of block up the machine gradually, observe it cross ASD after again release right building side umbrella dish.After right building side umbrella dish release, the TTE should slice noodles more to sweep to check, observation ASD whether a week is left or not, right side umbrella the dish is located on ASD two sides respectively.Assurance the firm which block up a machine, Zhu Shu be appropriate to make an effort to lead long to pull, jostle to seal to block up a machine.If seal to block up a machine fixedly firm, seal to block up the machine right building side umbrella dish to be lead long to draw back, leave room to separate while leading long to pull, sealed to block up the machine left building side umbrella dish and move, the right building side umbrella dish returns to the home position after relax and recover to clip the appearance which separates at the room at first.Sealed to block up a machine and don’t move while jostle.Combine the observation has already had no remnants remaining reposition of redundant personnel, two sharp petals to return to flow and the lately- appear heart pack accumulate a liquid.
2 results
This set 30 after hair bore type ASD, in addition to a changes to surgery to open chest surgical operation after block up the machine move, the rest all seals to block up success.Use to seal to block up the machine 10 mm ～ 38 mms.(average 24 mms)Instant, 24 hs, a month and 3 months after the Shu, go a TTE check for 6 months, the point observation seals to block up machine position whether accommodation, stable firm.Had no remnants remaining reposition of redundant personnel and seal to block up a machine whether to the atrium wall and two sharp petals, three sharp petal activity creation influence, the heart pack which has without the new emergence accumulates a liquid.
3 discussions
Sealing to block up Shu through the pipe ASD is a kind of tiny create a treatment ASD after the hair bore of the valid method ［ be 3 ］s.TTE to case choice before the Shu, seal the leading and the whole distance in the choice, Shu of block up the machine model number to monitor, after the Shu curative effect evaluation and with visit to all have bigger value ［ 3 ］s.Among them most important of is before the Shu case choice.Should notice before the Shu several aspects are as follows:Before the Shu adopt greatly afferent minor axis to slice noodles diagraph path in front and back;Breastbone side four chambers slice noodles diagraph ago descended the empress last path and the sword next two chamberses slice the noodles diagraph top and bottom path as seal block up the judge of machine size standard side.The super voice slices noodles more to sweep to check careful observation the degree of hardness, length of ASD week good luck, in response to special attention the diagraph be apart from up the chamber vein, descend a chamber vein, coronal Dou and two sharp petals adhere to the distance of point in response to>5 mms, be apart from aorta Houpi no chance, but to the side ASD good luck should is hard good luck and>5 mm the ［ be 1~5 ］s.Seal a choice of block up the machine:Usually hard good luck ASD choice than ASD the biggest path big 2 mm ～ 8 mm the ［ be 6 ］s and the soft good luck adds the 7 mm ～ 13 mms not to wait ［ 4 ］s according to the ASD circumstance.ASD remnants the good luck soft hard degree has importance influence towards sealing to block up machine choice also, back and forth float dynamic ASD remnants good luck, pick and get rid of(take floating to move and doing not float to move cripple good luck to combine place as quasi-) ［ 6 ］s towards sealing to block up a machine to completely have no support dint ［ 1~6 ］s, measure hour should.At super voice under the surveillance the observation seal firm of block up the machine is successfully carry on ASD to seal to block up of another one key factor the ［ be 6 ］s.The pipe after send seal to block up a machine to the ASD one by one in order releases left building umbrella, loins and right building umbrella.When the loins card is at the ASD, two umbrellas are tightly stick in room to separate two sides, Zhu Shu appropriate make an effort to lead long to pull, jostle to seal to block up a machine several times, observe it whether firm ［ 5, 6 ］s, seal to block up a machine to observe after release whether it launch or not, counteract a much more colorful observation of Pu Lei to seal to block up a machine peripheral have already had no remnants remaining reposition of redundant personnel, judge the source of reposition of redundant personnel, measure the size of amount of reposition of redundant personnel, make sure that blocks up a machine fix the much firmer and colorful Pu Lei check release to seal to block up a machine after having no remnants remaining reposition of redundant personnel, after withdrawing to transport system, the observation seals to block up a machine appearance after release variety and periphery structure of relation.This case has a to block up after the machine Shu a 24 hs to move to change to surgery to open chest surgical operation and analyze it to fail reason: is experience shortage, the ASD peripheral survive room separate weaker, float to float, the soft good luck once picked and get rid of little, prop up dint towards sealing to block up a machine have no enough.Above-mentioned ASD periphery survive room of the circumstance elucidation’s separating thickness is 2 ］s to the importance ［ which seals to block up Shu.Rest 29 all seal to block up success.Combine in Shu after go a TTE check for instant, 24 hs, a month, 3 months and 6 months with visit, didn’t discover cripple remaining reposition of redundant personnel, two sharp petals return to flow and the lately- appear heart pack accumulate a liquid
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