Changes Of Cardiac Function And Blood Routine In Children With Atrial Septal Defect Before And After Intervention

Objective:1.To evaluate the cardiac morphological and electrocardiogram changes in children with before and 24 h after percutaneous cardiac catheterization through clinical manifestation,echocardiography and electrocardiogram,and to evaluate the effect of interventional surgery on cardiac function in children with atrial septal defect.2.To compare the atrial septal deficiency by collecting the results of blood routine before and 24 h after operation,white blood cell count,platelet count,hemoglobin and hematocrit were used to evaluate the effect of interventional operation on blood system.Mmethods: Methods the data of interventional occlusion of atrial septal defect in heart center of Qingdao women and children's Hospital in 1-12 month January 2017 were retrospectively analyzed.Criteria for entry: 1.Patients with isolated atrial septal defects were treated with percutaneous cardiac catheterization;2.No other cardiac malformations needed to be treated for the same period;3.No other systemic disease,such as respiratory system,hereditary metabolic disease,and other systemic diseases.Among them,there were18 male and 28 female,age 0.8-15 years,average age(3.83±0.62)years,weight 6.3-81 kg,average weight(18.25±2.63)kg,body surface area 0.32-1.95m2,average surface area(1.05±0.41)m2,atrial septal defect diameter 6-19 mm,average diameter(11.05±0.59)mm,cardiothoracic ratio 0.38-0.62,average cardiothoracic ratio(0.53±0.01)and the number of days in hospital was 5-10 days.All the children measured the internal diameter of the atrioventricular cavity,the end diastolic thickness of the ventricular septum,the ejection fraction,the internal diameter of the aorta,the inner diameter of the main pulmonary artery,the end diastolic diameter of the left ventricle and the short axis shortening rate of the left ventricle before and after the interventional operation of the atrial septal defect.Electrocardiographic examination recorded the changes of PR interval and T wave before and 24 h after operation of atrial septal defect in every child,and whether there was arrhythmia.Blood routine results before and after operation were collected,and white blood cell count,hemoglobin,platelet count and hematocrit were compared.In this study,all the data are expressed with mean standard deviation(x ±s),and themeasurement data in this paper conform to the normal distribution,and all the above data are analyzed by SPSS 17 for Windows software package.In this article,the statistical values of before and 24 h after transcatheter closure of atrial septal defect in children were compared by paired t test.The difference was statistically significant in P<0.05.Results:46 cases had successfully completed the interventional operation of atrial septal defect.No hemolysis,III degree atrioventricular block,pericardial tamponade and exfoliation of occluder,displacement and other serious complications were not found after operation.2 cases sieved atrial septal defect still had residual shunt after operation,and the width of shunt bundle was <2mm.Comparison of atrial septal defect by percutaneous catheter intervention in children before and 24 h after operation.The internal diameter of the main pulmonary artery decreased than before operation,the difference was not statistically significant(P>0.05).The right atrial diameter and right ventricular diameter decreased significantly compared with those before operation,and the difference was statistically significant(P<0.05).The end-diastolic thickness and left ventricular end-diastolic diameter of ventricular septum increased significantly compared with that before operation(P<0.05).The internal diameter of the left atrium,the posterior diastolic thickness of the left ventricle,the internal diameter of the aorta,the end-systolic diameter of the left ventricle,the ejection fraction and the shortening of the left ventricular short axis were all higher than those before the operation,but the difference was not statistically significant(P>0.05).The PR interval and QRS time of 24 h after operation was shorter than that before operation,and the difference was statistically significant(P<0.05).The QTc interval was shorter than that before operation,and the difference was not statistically significant(P>0.05).The blood routine before and 24 h after the intervention of the atrial septal defect showed that the platelet count were lower than those before the operation,and the difference was statistically significant(P<0.05).The white blood cell count was higher than that before operation(P<0.05).There was no significant difference in hemoglobin and hematocrit after operation(P>0.05).Conclusion: 1.The left atrium diameter,left ventricular diameter,left ventricular enddiastolic thickness and inner diameter of the aorta were higher in the patients with atrial septal defect after the operation,suggesting that the left to right shunt was blocked and the left heart volume increased after operation.The left heart function was monitored afteroperation,and the cardiac function was added when necessary.2.24 h After operation the main pulmonary artery diameter,right atrial diameter and right ventricular diameter decreased,and the PR interval shortened,suggesting that the right heart volume load was reduced and the right ventricular function was improved.3.24 h After operation the platelet count of was reduced,indicating that there was no significant damage.Attention monitoring had hemolysis,and normal anticoagulant therapy should be used to monitor the tendency of hemolysis.Hemoglobin and hematocrit showed no significant decrease,indicating less intraoperative blood loss,but still need close monitoring after operation.