\u672c\u6587\u4f5c\u8005\uff1a\u5f20\u5cf0 \u6f58\u6587\u5fd7 \u5468\u8fbe\u65b0<\/p>\n
\u51e0\u4e2a\u4e16\u7eaa\u524d\u4eba\u4eec\u5c31\u4ece\u89e3\u5256\u7ed3\u6784\u4e0a\u8ba4\u8bc6\u4e86\u5375\u5706\u5b54\u672a\u95ed\uff08patent fommen ovale\uff0cPFO\uff09\uff0c\u4f46\u5f53\u65f6\u8ba4\u4e3a\u5176\u4ec5\u662f\u623f\u95f4\u9694\u7684\u539f\u53d1\u9694\u548c\u7ee7\u53d1\u9694\u6ca1\u6709\u5b8c\u5168\u878d\u5408\u6240\u5f62\u6210\u7684\u88c2\u9699\u6837\u901a\u9053\uff0c\u6ca1\u6709\u4efb\u4f55\u4e34\u5e8a\u610f\u4e49\u3002\u8fd1\u5e74\u6765, \u968f\u7740\u5bf9PFO\u7814\u7a76\u7684\u4e0d\u65ad\u6df1\u5165\uff0c\u5173\u4e8ePFO\u5f15\u8d77\u5404\u79cd\u5404\u6837\u7684\u4e34\u5e8a\u7efc\u5408\u5f81\u8d8a\u6765\u8d8a\u53d7\u5230\u4e34\u5e8a\u91cd\u89c6\uff0c\u5305\u62ec\u9690\u6e90\u6027\u5352\u4e2d\uff08cryptogenic stroke\uff0cCS\uff09\u3001\u77ed\u6682\u6027\u8111\u7f3a\u8840\u53d1\u4f5c\uff08transient ischemic attack\uff0cTIA\uff09\u3001\u504f\u5934\u75db\u3001\u659c\u5367\u547c\u5438-\u76f4\u7acb\u578b\u4f4e\u6c27\u8840\u75c7\u3001 \u7761\u7720\u547c\u5438\u6682\u505c\u7efc\u5408\u5f81\u3001\u51a0\u72b6\u52a8\u8109\u6b63\u5e38\u7684\u5fc3\u808c\u6897\u6b7b\u53ca\u795e\u7ecf\u51cf\u538b\u75c5\u7b49\u3002\u5c24\u5176\u662fCS\u548c\u504f\u5934\u75db, \u4e0d\u4ec5\u7ed9\u60a3\u8005\u9020\u6210\u5de8\u5927\u7684\u8eab\u4f53\u75db\u82e6\u548c\u7cbe\u795e\u6298\u78e8, \u540c\u65f6\u4e5f\u7ed9\u5bb6\u5ead\u548c\u793e\u4f1a\u5e26\u6765\u4e86\u6c89\u91cd\u8d1f\u62c5\u3002\u76ee\u524d\u7814\u7a76\u663e\u793a\u9488\u5bf9\u75c5\u56e0\u6cbb\u7597\uff0c\u5c01\u95ed\u9ad8\u5371\u4eba\u7fa4\u7684\u5f00\u653e\u7684\u5375\u5706\u5b54\uff0c\u6709\u671b\u964d\u4f4e\u60a3\u8005\u53cd\u5e38\u6813\u585e\u4e8b\u4ef6\u7684\u53d1\u751f\u7387\u4e0e\u504f\u5934\u75db\u7684\u53d1\u75c5\u3002\u672c\u6587\u4ece\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u5165\u624b\uff0c\u56de\u987e\u8fd1\u5e74\u6765\u56fd\u5185\u5916\u7ecf\u5bfc\u7ba1\u5c01\u5835 PFO\u9884\u9632\u5352\u4e2d\u53ca\u504f\u5934\u75db\u7684\u7814\u7a76\u6210\u679c, \u65e8\u5728\u660e\u786e\u80fd\u4ece\u5c01\u5835\u6cbb\u7597\u4e2d\u83b7\u76ca\u7684PFO\u4eba\u7fa4\u3002<\/p>\n
\u4e00<\/p>\n
\u6d41\u884c\u75c5\u5b66\u53ca\u81f4\u75c5\u673a\u7406<\/p>\n
\u5375\u5706\u5b54\u662f\u4f4d\u4e8e\u623f\u95f4\u9694\u7684\u539f\u53d1\u9694\u548c\u7ee7\u53d1\u9694\u4ea4\u754c\u5904\u7684\u88c2\u9699\uff08\u56fe1\uff09\u3002\u5b83\u7684\u7279\u70b9\u662f\u539f\u53d1\u9694\u5728\u53f3\u4e0a\u65b9\uff0c\u7ee7\u53d1\u9694\u5728\u5de6\u4e0b\u65b9\uff0c\u4e24\u8005\u5448\u4ea4\u53c9\u72b6\u6001\uff0c\u800c\u539f\u53d1\u9694\u539a\u5b9e\u575a\u56fa\uff0c\u800c\u7ee7\u53d1\u9694\u67d4\u8f6f\u53ef\u4ee5\u88ab\u5916\u754c\u538b\u529b\u63a8\u52a8\u3002\u56e0\u6b64\uff0c\u5982\u679c\u53f3\u8fb9\uff08\u53f3\u5fc3\u623f\uff09\u538b\u529b\u5927\u4e8e\u5de6\u8fb9\u65f6\uff0c\u7ee7\u53d1\u9694\u53ef\u4ee5\u88ab\u63a8\u79bb\u539f\u53d1\u9694\u4f7f\u5f97\u5375\u5706\u5b54\u5f00\u653e\uff1b\u800c\u5982\u679c\u53f3\u8fb9\uff08\u53f3\u5fc3\u623f\uff09\u538b\u529b\u4f4e\u4e8e\u5de6\u8fb9\u65f6\uff0c\u7ee7\u53d1\u9694\u53ef\u4ee5\u88ab\u63a8\u5411\u539f\u53d1\u9694\u4f7f\u5f97\u5375\u5706\u5b54\u5173\u95ed\u3002\u5375\u5706\u5b54\u5728\u80ce\u513f\u53d1\u80b2\u8fc7\u7a0b\u4e2d\u4f5c\u4e3a\u6c9f\u901a\u5de6\u3001\u53f3\u5fc3\u623f\u4e4b\u95f4\u7684\u5148\u5929\u901a\u9053\uff0c\u4e3a\u80ce\u513f\u4f9b\u6c27\u8d77\u5230\u91cd\u8981\u4f5c\u7528\u3002\u80ce\u513f\u5728\u5728\u5b50\u5bab\u5185\uff0c\u5176\u80ba\u90e8\u662f\u4e0d\u5de5\u4f5c\u7684\uff0c\u80ce\u513f\u6240\u9700\u7684\u6c27\u6765\u81ea\u4e8e\u6bcd\u4eb2\uff1a\u5927\u91cf\u542b\u6c27\u7684\u8840\u7ecf\u8110\u9759\u8109\u8fdb\u5165\u53f3\u5fc3\uff0c\u53f3\u5fc3\u538b\u529b\u5927\uff0c\u5375\u5706\u5b54\u5f00\u653e\uff0c\u8840\u6db2\u7ecf\u5375\u5706\u5b54\u4ece\u53f3\u5fc3\u5230\u4e86\u5de6\u5fc3\u8fdb\u5165\u5168\u8eab\u7684\u4f53\u5faa\u73af\u3002\u51fa\u751f\u540e\uff0c\u5a74\u513f\u80ba\u5f00\u59cb\u5de5\u4f5c\uff0c\u5438\u7eb3\u5916\u754c\u6c27\u6c14\uff0c\u80ba\u5faa\u73af\u91cf\u5267\u70c8\u589e\u52a0\uff0c\u5176\u8840\u56de\u5230\u5de6\u5fc3\u623f\u4f7f\u5f97\u5de6\u5fc3\u623f\u538b\u529b\u589e\u9ad8\uff0c\u538b\u8feb\u5375\u5706\u5b54\u7ee7\u53d1\u9694\u7684\u74e3\u819c\u4f7f\u4e4b\u5173\u95ed\uff0c \u800c\u6b64\u65f6\u53f3\u5fc3\u7684\u8840\u4e5f\u4e0d\u9700\u8981\u901a\u8fc7\u5375\u5706\u5b54\u6d41\u5230\u5de6\u5fc3\u3002\u968f\u7740\u5a74\u513f\u7684\u751f\u957f\uff0c\u5375\u5706\u5b54\u74e3\u819c\u7c98\u8fde\u50f5\u76f4\uff0c\u6d3b\u52a8\u51cf\u5f31\uff0c\u7ea4\u7ef4\u7ec4\u7ec7\u589e\u751f\u4f7f\u5b54\u9053\u95ed\u5408\uff0c\u5728\u7ed3\u6784\u4e0a\u5173\u95ed\u5375\u5706\u5b54\u3002\u4e00\u822c\u5728\u51fa\u751f\u540e\u7b2c8\u4e2a\u6708\u6216\u66f4\u957f\u65f6\u95f4\uff0c\u5b8c\u5168\u65ad\u7edd\u5de6\u3001\u53f3\u4e24\u5fc3\u623f\u95f4\u7684\u8840\u8fd0\uff0c1\u5e74\u540e\u8fbe\u5230\u89e3\u5256\u4e0a\u5173\u95ed\u3002\u82e5\u5927\u4e8e3\u5c81\u7684\u5e7c\u513f\u5375\u5706\u5b54\u74e3\u672a\u80fd\u4e0e\u7ee7\u53d1\u9694\u5b8c\u5168\u878d\u5408\u79f0\u4e3aPFO\u3002PFO\u5f62\u6210\u7684\u539f\u56e0\u6709\u5f85\u8fdb\u4e00\u6b65\u7684\u7814\u7a76\uff0c\u76ee\u524d\u8003\u8651\u53ef\u80fd\u4e0e\u5e38\u8272\u4f53\u663e\u6027\u9057\u4f20\u6709\u5173\u3002PFO\u6700\u521d\u662f\u5728\u5c38\u68c0\u65f6\u53d1\u73b0\u7684\uff0c\u5176\u53d1\u751f\u7387\u5927\u7ea6\u4e3a27\uff05-29\uff05\u3002\u4eba\u7fa4\u4e2d\u5927\u7ea625\uff05\u7684\u6709PFO\uff0c\u7136\u800c\u5927\u591a\u6570PFO\u60a3\u8005\u6ca1\u6709\u663e\u8457\u7684\u4e34\u5e8a\u75c7\u72b6\uff0c\u5176\u4e2d\u4ec52\uff05\u7684\u60a3\u8005\u4f1a\u51fa\u73b0\u4e34\u5e8a\u75c7\u72b6\u3002 <\/p>\n
\u56fe1. PFO\u7684\u89e3\u5256\u5b66\u793a\u610f\u56fe<\/p>\n
\u7531\u4e8e\u6b63\u5e38\u60c5\u51b5\u4e0b\u5de6\u5fc3\u623f\u538b\u529b\u6bd4\u53f3\u5fc3\u623f\u538b\u529b\u9ad83-5 mmHg\uff0cPFO\u5e94\u5904\u4e8e\u5173\u95ed\u72b6\u6001\u3002\u4f46\u8bb8\u591a\u751f\u7406\u6027\u6216\u75c5\u7406\u6027\u56e0\u7d20\u90fd\u53ef\u4ee5\u5f15\u8d77\u53f3\u623f\u538b\u529b\u4e00\u8fc7\u6027\u6216\u6301\u7eed\u6027\u5347\u9ad8\uff0c\u5982\u5fc3\u623f\u95f4\u7684\u5468\u671f\u6027\u538b\u529b\u5dee\u53d8\u5316\uff0cValsalva\u52a8\u4f5c\u672b\u3001\u54b3\u55fd\u3001\u6f5c\u6c34\u7b49\uff0c\u53f3\u5fc3\u623f\u538b\u529b\u8d85\u8fc7\u5de6\u5fc3\u623f\u538b\u529b\u65f6\uff0c\u5de6\u4fa7\u8584\u5f31\u7684\u539f\u53d1\u9694\u88ab\u63a8\u5f00\uff0c\u51fa\u73b0\u53f3\u5411\u5de6\u5206\u6d41 (right to left shunt\uff0cRLS)\u3002\u80ba\u52a8\u8109\u9ad8\u538b\u3001\u6162\u6027\u963b\u585e\u6027\u80ba\u90e8\u75be\u60a3\u3001\u80ba\u6813\u585e\u7b49\u5219\u5f15\u8d77\u53f3\u623f\u538b\u6162\u6027\u5347\u9ad8\u3002\u4f46\u9664\u4e86\u538b\u529b\u68af\u5ea6\u53d8\u5316\u5916\uff0cPFO\u7684\u89e3\u5256\u53d8\u5f02\u5bf9\u53f3\u5411\u5de6\u5206\u6d41\u7684\u5927\u5c0f\u53ca\u6301\u7eed\u65f6\u95f4\u6709\u5f88\u5927\u5f71\u54cd\u3002<\/p>\n
\u76f4\u5f84\u8f83\u5927\u7684PFO\u53ef\u5728\u5c40\u90e8\u5f62\u6210\u8840\u6db2\u6da1\u6d41\u3001\u8840\u6813\u3001\u623f\u95f4\u9694\u81a8\u51fa\u7624\u7b49\uff0c\u9759\u8109\u7cfb\u7edf\u5185\u5404\u7c7b\u6813\u5b50\u53ef\u901a\u8fc7PFO\u8fdb\u5165\u5de6\u5fc3\u623f\uff0c\u53c2\u4e0e\u4f53\u5faa\u73af\u9020\u6210\u8111\u52a8\u8109\u6216\u5176\u4ed6\u52a8\u8109\u7684\u53cd\u5e38\u6813\u585e\uff0c\u5f15\u8d77\u7f3a\u8840\u6027\u8111\u5352\u4e2d\u3002\u968f\u7740\u8ba4\u8bc6\u7684\u52a0\u6df1\uff0c\u9010\u6e10\u8ba4\u8bc6\u5230PFO\u662f\u53cd\u5e38\u6027\u6813\u585e\u7684\u75c5\u7406\u89e3\u5256\u5b66\u57fa\u7840\u3002\u6839\u636e PFO \u7684\u89e3\u5256\u7ed3\u6784\u548c\u623f\u95f4\u9694\u7279\u5f81\uff0c\u5c06\u5176\u5206\u4e3a\u7b80\u5355\u578b PFO\u548c\u590d\u6742\u578bPFO\u4e24\u79cd\u7c7b\u578b\u3002\u590d\u6742\u6027PFO\u7684\u7279\u5f81\u4e3a\u6ee1\u8db3\u4e0b\u9762\u6761\u4ef6\u4e4b\u4e00\u8005\uff08\u56fe2\uff09\uff1a\u957f\u96a7\u9053\u578b(>8 mm)\u3001\u5408\u5e76\u623f\u95f4\u9694\u81a8\u51fa\u7624(atrial septal aneurysm\uff0cASA)\u3001\u5408\u5e76\u4e0b\u8154\u9759\u8109\u74e3\u6216\u5e0c\u963f\u91cc\u6c0f\u7f51\u3001\u7ee7\u53d1\u95f4\u9694\u80a5\u539a(>10 mm)\u53ca\u53d1\u623f\u95f4\u9694\u7f3a\u635f(atrial septal defect\uff0cASD)\u3002\u4e0d\u5177\u4e0a\u8ff0\u6761\u4ef6\u8005\u4e3a\u7b80\u5355\u578bPFO\u3002<\/p>\n
\u56fe2. \u590d\u6742PFO\u7684\u89e3\u5256\u5b66\u7279\u5f81<\/p>\n
\u4e8c<\/p>\n
\u8bca\u65ad\u53ca\u68c0\u67e5\u65b9\u6cd5<\/p>\n
\u4e34\u5e8a\u4e0aPFO\u4e3b\u8981\u901a\u8fc7\u8d85\u58f0\u5fc3\u52a8\u56fe\u548c\u58f0\u5b66\u9020\u5f71\u8bca\u65ad\uff0c\u5305\u62ec\u7ecf\u80f8\u8d85\u58f0\u5fc3\u52a8\u56fe\uff08transthoracic echo-cardiography,TTE\uff09\u3001\u7ecf\u80f8\u8d85\u58f0\u5fc3\u52a8\u56fe\u58f0\u5b66\u9020\u5f71\uff08contrast transthoracic echocardiography\uff0ccTTE\uff09\u3001\u7ecf\u98df\u7ba1\u8d85\u58f0\u5fc3\u52a8\u56fe\uff08transesophageal echocardiography,TEE\uff09\u3001\u5bf9\u6bd4\u589e\u5f3a\u7ecf\u9885\u591a\u666e\u52d2\u8d85\u58f0\u58f0\u5b66\u9020\u5f71 \uff08contrast-enhanced transcranial doppler,cTCD\uff09\u7b49\u6765\u68c0\u67e5\u548c\u8bca\u65ad\u3002<\/p>\n
1.TTE <\/p>\n
\u5e38\u89c4 TTE \u867d\u53ef\u6e05\u695a\u663e\u793a\u5fc3\u810f\u7ed3\u6784\uff0c\u4f46\u7531\u4e8e\u6210\u4eba\u53d7\u5404\u79cd\u56e0\u7d20\u5982\u80a5\u80d6\u3001\u80ba\u6c14\u8fc7\u591a\u7b49\u7684\u5f71\u54cd\uff0c\u5bf9PFO\u7075\u654f\u5ea6\u8f83\u4f4e\uff0c\u6613\u6f0f\u8bca\u3002<\/p>\n
2.TEE <\/p>\n
TEE\u53ef\u6e05\u6670\u663e\u793a\u623f\u95f4\u9694\u7684\u7ed3\u6784\u3001\u5927\u5c0f\u548c\u5206\u578b\uff0c\u662f\u76ee\u524d\u8bca\u65adPFO\u7684\u201c\u91d1\u6807\u51c6\u201d\u548c\u9996\u9009\u65b9\u6cd5\uff0c\u7075\u654f\u5ea6\u4e3a90%\uff0c\u7279\u5f02\u6027>95%\u3002TEE\u98df\u7ba1\u63a2\u5934\u8ddd\u79bb\u5de6\u5fc3\u623f\u6700\u8fd1\uff0c\u4e0d\u53d7\u80f8\u9aa8\u5f71\u54cd\uff0c\u80fd\u83b7\u5f97\u6e05\u6670\u7684\u623f\u95f4\u9694\u4e8c\u7ef4\u56fe\u50cf\uff0c\u66f4\u4e3a\u76f4\u89c2\u3001\u51c6\u786e\u7684\u89c2\u5bdf\u60a3\u8005\u7684\u539f\u53d1\u9694\u4e0e\u7ee7\u53d1\u9694\u7684\u878d\u5408\u3001\u7c98\u8fde\u60c5\u51b5 \u3002TEE\u53ef\u4ee5\u6d4b\u91cfPFO\u7684\u9759\u606f\u76f4\u5f84\u548c\u5f00\u653e\u76f4\u5f84(\u6709\u6548 Valsalva \u52a8\u4f5c\u540e\u6d4b\u91cf\u7684\u6700\u5927PFO\u76f4\u5f84)\u3002\u4f9d\u636e\u5176\u5f00\u653e\u76f4\u5f84\uff0c\u53ef\u5c06 PFO\u5206\u4e3a\u5927PFO( \u22654.0 mm)\u3001\u4e2dPFO(2.0-3.9 mm) \u548c\u5c0fPFO(<2.0 mm)\u4e09\u79cd\u7c7b\u578b\u3002<\/p>\n
\u56fe3. \u7ecf\u98df\u9053\u8d85\u58f0\uff08TEE\uff09<\/p>\n
3.cTTE <\/p>\n
cTTE \u68c0\u67e5\u53ef\u4e86\u89e3\u6709\u65e0RLS\u3002\u901a\u5e38\u7528\u52a0\u8840\u6fc0\u6d3b\u751f\u7406\u76d0\u6c34\u4f5c\u4e3a\u5bf9\u6bd4\u5242\uff0c\u7ecf\u8098\u6b63\u4e2d\/\u8d35\u8981\u9759\u8109\u63a8\u6ce8\u6fc0\u6d3b\u751f\u7406\u76d0\u6c34\u3002\u89c2\u5bdf\u9759\u606f\u72b6\u6001\u4e0b\u53ca\u6709\u6548 Valsalva \u52a8\u4f5c\u540e\u53f3\u5fc3\u663e\u5f71\u540e 5 \u4e2a\u5fc3\u52a8\u5468\u671f\u5185\u5de6\u5fc3\u5185\u5fae\u6ce1\u663e\u5f71\u7684\u6570\u91cf\u3002RLS\u91cf\u591a\u5c11\u7684\u6309\u201c\u5375\u5706\u5b54\u672a\u95ed\u9884\u9632\u6027\u5c01\u5835\u672f\u4e2d\u56fd\u4e13\u5bb6\u5171\u8bc6\u201d\u7684\u6807\u51c6\u8ba1\u7b97\uff0c\u4ee5\u9759\u6b62\u5355\u5e27\u56fe\u50cf\u4e0a\u5de6\u5fc3\u8154\u5185\u51fa\u73b0\u7684\u5fae\u6ce1\u6570\u91cf\u8fdb\u884c\u5206\u7ea7: <\/p>\n
cTTE\u68c0\u67e5\u53d7\u5f71\u54cd\u56e0\u7d20\u8f83\u591a\uff0c\u548c\u68c0\u67e5\u8005\u7684\u64cd\u4f5c\u53ca\u60a3\u8005\u914d\u5408\u5ea6\u6709\u5173\uff0c\u6709\u4e00\u5b9a\u5047\u9634\u6027\u6982\u7387\uff0c\u91cd\u590d\u68c0\u67e5 RLS\u6709\u4e00\u5b9a\u5dee\u5f02\uff0c\u4f46\u5176\u8bca\u65ad RLS \u7684\u7279\u5f02\u6027\u4e3a97%-100%\u3002<\/p>\n
4. cTCD <\/p>\n
cTCD\u662f\u901a\u8fc7\u5728\u9759\u606f\u72b6\u6001\u53ca Valsalva \u52a8\u4f5c\u540e\u6ce8\u5c04\u6fc0\u6d3b\u751f\u7406\u76d0\u6c34\uff0c\u89c2\u5bdf\u9885\u8111\u5faa\u73af\u51fa\u73b0\u6c14\u6ce1\u7684\u591a\u5c11\u5224\u65ad RLS\u3002cTCD\u8bca\u65ad RLS \u654f\u611f\u6027\u4e3a 68%-100%\uff0c\u7279\u5f02\u6027\u4e3a 65%-100%\uff0c\u5176\u7f3a\u70b9\u5728\u4e8e\u4e0d\u80fd\u76f4\u63a5\u663e\u793a\u623f\u95f4\u9694\u7684\u7ed3\u6784\u7279\u5f81\uff0c\u96be\u4ee5\u533a\u5206 RLS \u7684\u6765\u6e90\u4e8e\u5fc3\u5185\u5206\u6d41\u6216\u80ba\u5185\u5206\u6d41\u3002<\/p>\n
\u4e34\u5e8a\u5e94\u7528\u4e2d\uff0c\u4e00\u822c\u5148\u505a cTCD \u6216 cTTE \u68c0\u67e5\uff0c\u9633\u6027\u8005\u53ef\u8fdb\u4e00\u6b65 cTEE \u68c0\u67e5\uff0c\u786e\u5b9a\u5206\u6d41\u6765\u6e90\uff0c\u660e\u786e\u662f\u5426\u4e3a PFO\u3002\u5bf9\u4e8e\u9634\u6027\u8fd9\u4e5f\u4e0d\u80fd\u5b8c\u5168\u6392\u9664PFO\u3002\u5bf9\u4e8ePFO\u8bca\u65ad\u6765\u8bf4\uff0ccTTE\u548cTTE\u4e24\u8005\u662f\u4e92\u8865\u7684\uff0c\u6709\u4e00\u79cd\u9633\u6027\u5373\u53ef\u8bca\u65adPFO\u3002<\/p>\n
\u4e09<\/p>\n
\u8111\u6897\u5408\u5e76PFO\u4e34\u5e8a<\/p>\n
\u7814\u7a76\u8bc1\u636e\u53ca\u5c01\u5835\u6307\u5f81<\/p>\n
1. PFO\u4e0e\u9690\u6e90\u6027\u5352\u4e2d\u7684\u76f8\u5173\u6027<\/p>\n
\u591a\u9879\u524d\u77bb\u6027\u7814\u7a76\u8868\u660e\uff0cPFO\u4e0e\u9690\u6e90\u6027\u5352\u4e2d\u7684\u53d1\u75c5\u5b58\u5728\u660e\u663e\u7684\u76f8\u5173\u6027\u3002\u4f4e\u9f84\u3001\u4f20\u7edf\u8840\u7ba1\u5371\u9669\u56e0\u7d20\uff08\u9ad8\u8840\u538b\u3001\u7cd6\u5c3f\u75c5\u3001\u65e2\u5f80\u5352\u4e2d\u6216TIA\u75c5\u53f2\u3001\u5438\u70df\u53f2\u7b49\uff09\u7684\u7f3a\u5931\u4e0e\u68c0\u6d4b\u51faPFO\u76f8\u5173\uff0c\u5373\u5e74\u9f84\u8d8a\u5c0f\u3001\u4f20\u7edf\u5371\u9669\u56e0\u7d20\u8d8a\u5c11\uff0c\u7f3a\u8840\u6027\u5352\u4e2d\u5c31\u8d8a\u6709\u53ef\u80fd\u7531PFO\u5f15\u8d77\u3002<\/p>\n
2.PFO\u5f15\u8d77CS\u7684\u53d1\u75c5\u673a\u5236 <\/p>\n
\u4e3b\u8981\u5305\u62ec\u4ee5\u4e0b\u51e0\u4e2a\u65b9\u9762\uff1a\uff081\uff09\u53cd\u5e38\u6813\u585e\uff1a\u6b63\u5e38\u53f3\u5fc3\u9759\u8109\u7cfb\u7edf\u7684\u8840\u662f\u6d41\u5230\u80ba\u52a8\u8109\uff0c\u4eba\u4f53\u9759\u8109\u7cfb\u7edf\u8840\u6813\u662f\u5f15\u8d77\u80ba\u90e8\u6813\u585e\uff1b\u800cPFO\u60a3\u8005\uff0c\u53f3\u5fc3\u9759\u8109\u7cfb\u7edf\u7684\u8840\u6813\u53ef\u901a\u8fc7PFO\u5230\u4e86\u5de6\u5fc3\uff0c\u6d41\u5411\u52a8\u8109\u7cfb\u7edf\u5230\u8fbe\u8111\u52a8\u8109\u5f15\u8d77\u8111\u5352\u4e2d\u3002\uff082\uff09PFO\u7ba1\u9053\u8840\u6813\uff1a\u957f\u96a7\u9053\u578bPFO\u7531\u4e8e\u8840\u6db2\u5728\u901a\u9053\u5185\u6d41\u901f\u51cf\u6162\u751a\u81f3\u505c\u6ede\uff0c\u6613\u5bfc\u81f4\u539f\u4f4d\u8840\u6813\u5f62\u6210\u3002\uff083\uff09\u623f\u95f4\u9694\u7624\uff1aPFO\u5408\u5e76\u623f\u95f4\u9694\u81a8\u51fa\u7624\u6613\u4e8e\u5f62\u6210\u539f\u4f4d\u8840\u6813\uff0c\u76f4\u63a5\u9020\u6210\u6813\u585e\u3002\uff084\uff09\u5fc3\u5f8b\u5931\u5e38\uff1aPFO\u60a3\u8005\u5982\u5b58\u5728\u4e00\u8fc7\u6027\u623f\u6027\u5fc3\u5f8b\u5931\u5e38\uff08\u5982\u9635\u53d1\u6027\u5fc3\u623f\u98a4\u52a8\uff09\u7684\u6f5c\u5728\u5371\u9669\uff0c\u4f1a\u8fdb\u4e00\u6b65\u63d0\u9ad8\u53d1\u751f\u6813\u585e\u7684\u98ce\u9669\u3002<\/p>\n
3. PFO\u76f8\u5173CS\u7684\u5f71\u50cf\u5b66\u7279\u5f81 <\/p>\n
\u7814\u7a76\u8868\u660e\uff0c\u4f34\u6709PFO\u7684\u9690\u6e90\u6027\u5352\u4e2d\u5177\u6709\u5178\u578b\u4e34\u5e8a\u653e\u5c04\u5b66\u7279\u5f81\u3002\u4e0e\u65e0PFO\u7684\u9690\u6e90\u6027\u5352\u4e2d\u76f8\u6bd4\uff0cPFO\u76f8\u5173\u9690\u6e90\u6027\u5352\u4e2d\u60a3\u8005\u5f71\u50cf\u4e0a\u591a\u4e3a\u591a\u8840\u7ba1\u5206\u5e03\u533a\u7684\u591a\u53d1\u6563\u5728\u76f4\u5f84\u226415mm\u7684\u5c0f\u6897\u6b7b\uff0c\u7f6a\u72af\u8840\u7ba1\u591a\u4e3a\u7d2f\u53ca\u5927\u8111\u540e\u52a8\u8109\u7684\u540e\u5faa\u73af\u8840\u7ba1\uff08\u56fe3\uff09\u3002\u8fd9\u53ef\u80fd\u4e0ePFO\u7684\u751f\u7406\u7ed3\u6784\u6709\u5173\uff0c\u4f5c\u4e3a\u4e00\u4e2a\u201c\u8fc7\u6ee4\u5668\u201d\uff0c\u53ea\u6709\u6bd4\u5375\u5706\u5b54\u66f4\u5c0f\u7684\u6813\u5b50\u624d\u80fd\u901a\u8fc7\u5e76\u5f15\u8d77\u5352\u4e2d\uff0c\u56e0\u6b64\u5f71\u50cf\u4e0a\u5e38\u8868\u73b0\u4e3a\u5c0f\u6897\u6b7b\u7076\uff1b\u6838\u7d20\u663e\u50cf\u7b49\u6280\u672f\u663e\u793a\uff0c\u5728Valsalva\u52a8\u4f5c\u8bf1\u53d1\u4e0b\u540e\u5faa\u73af\u8840\u6d41\u901f\u5ea6\u53ca\u8840\u6d41\u91cf\u5747\u663e\u8457\u9ad8\u4e8e\u524d\u5faa\u73af\uff0c\u56e0\u6b64\u6813\u5b50\u901a\u8fc7\u672a\u95ed\u7684\u5375\u5706\u5b54\u8fdb\u5165\u540e\u5faa\u73af\u8840\u7ba1\u6982\u7387\u4e5f\u660e\u663e\u589e\u52a0\u3002<\/p>\n
\u56fe4. \u5375\u5706\u5b54\u672a\u95ed\u76f8\u5173\u9690\u6e90\u6027\u5352\u4e2d\u56fe\u50cf<\/p>\n
4. \u4e34\u5e8a\u76f8\u5173\u7814\u7a76 <\/p>\n
\u65e9\u5e74\u7684\u5c01\u5835PFO\u9884\u9632\u8111\u5352\u4e2d\u7684\u7814\u7a76\u5747\u662f\u89c2\u5bdf\u6027\u7814\u7a76\uff0c\u7ed3\u679c\u5747\u663e\u793a\u5c01\u5835PFO\u9884\u9632\u8111\u5352\u4e2d\u590d\u53d1\u662f\u4e00\u79cd\u5b89\u5168\u3001\u6709\u6548\u7684\u65b9\u6cd5\u3002\u4f46\u8fd9\u4e9b\u90fd\u662f\u975e\u968f\u673a\u5bf9\u7167\u7814\u7a76\uff0c\u4f7f\u5f97\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\uff08randomized controlled trial\uff0cRCT\uff09\u7684\u7ed3\u679c\u5907\u53d7\u671f\u5f85\u3002\u4f46\u65e9\u671f\u53d1\u5e03\u7684RCT\u7814\u7a76\u5e76\u672a\u663e\u793a\u5c01\u5835 PFO\u5728\u9884\u9632\u9690\u6e90\u6027\u5352\u4e2d\u65b9\u9762\u4f18\u4e8e\u836f\u7269\u6cbb\u7597\u3002CLOSURE I \u662f\u9996\u4e2a\u91c7\u7528\u5355\u7eaf\u836f\u7269\u6cbb\u7597\u4e0e\u7ecf\u5bfc\u7ba1PFO\u5c01\u5835\u9884\u9632\u7f3a\u8840\u6027\u5352\u4e2d\u6216TIA\u7684\u524d\u77bb\u6027\u3001\u591a\u4e2d\u5fc3RCT, \u65e8\u5728\u8bc4\u4ef7\u5728\u9884\u9632\u7f3a\u8840\u6027\u5352\u4e2d\u6216 TIA\u590d\u53d1\u65b9\u9762, \u4f7f\u7528 STARFlex \u5c01\u5835\u5668\u884c\u7ecf\u5bfc\u7ba1PFO\u5c01\u5835\u662f\u5426\u4f18\u4e8e\u5355\u7eaf\u836f\u7269\u6cbb\u7597\uff0c2\u5e74\u968f\u8bbf\u7ed3\u675f\u65f6\u4e24\u7ec4\u5352\u4e2d\u53d1\u751f\u7387\u548cTIA\u53d1\u751f\u7387\u5747\u65e0\u7edf\u8ba1\u5b66\u5dee\u5f02\u3002RESPECT\u8bd5\u9a8c\u662f\u4e00\u9879\u524d\u77bb\u6027\u3001\u591a\u4e2d\u5fc3RCT\u53ca\u4e8b\u4ef6\u9a71\u52a8\u6027\u8bd5\u9a8c\uff0c\u6bd4\u8f83\u91c7\u7528 Amplatzer PFO \u5c01\u5835\u5668\u7ecf\u5bfc\u7ba1 PFO\u5c01\u5835\u662f\u5426\u4f18\u4e8e\u836f\u7269\u6cbb\u7597\uff08\u6297\u8840\u5c0f\u677f\u6216\u534e\u6cd5\u6797\u6297\u51dd\u6cbb\u7597\uff09\uff0c\u4e2d\u4f4d\u968f\u8bbf2.1\u5e74\u7ed3\u679c\u663e\u793a, \u4e24\u7ec4\u518d\u53d1\u7f3a\u8840\u6027\u5352\u4e2d\u6216\u65e9\u671f\u6b7b\u4ea1\u7684\u53d1\u751f\u7387\u5206\u522b\u4e3a1.8%\u548c3.3%\uff08P=0.08\uff09\u3002PC\u7814\u7a76\u662fRESPECT\u7684\u59ca\u59b9\u8bd5\u9a8c, \u6bd4\u8f83\u91c7\u7528Amplatzer PFO\u5c01\u5835\u5668\u8fdb\u884c\u7ecf\u5bfc\u7ba1PFO\u5c01\u5835\u548c\u836f\u7269\u6cbb\u7597PFO\u5408\u5e76\u53cd\u5e38\u6813\u585e\u60a3\u8005\u7684\u7597\u6548\uff0c\u5e73\u5747\u968f\u8bbf4.1\u5e74\uff0c\u4e24\u7ec4\u4e3b\u8981\u7ec8\u70b9\u4e8b\u4ef6\u6813\u585e\u590d\u53d1\u6216\u6b7b\u4ea1\u53d1\u751f\u7387\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49 3.5%\u6bd4 5.2%(P=0.34)\u3002<\/p>\n
\u8fd9\u51e0\u9879RCT\u7814\u7a76\u4e0e\u65e9\u671f\u7684\u4e00\u4e9b\u89c2\u5bdf\u6027\u7814\u7a76\u7ed3\u679c\u4e0d\u5c3d\u76f8\u540c\uff0cPFO\u5c01\u5835\u672a\u663e\u793a\u51fa\u8fc7\u591a\u83b7\u76ca\uff0c\u53ef\u80fd\u4e0e\u5c01\u5835\u5668\u5b58\u5728\u7f3a\u9677\u5982STARFlex \u6b8b\u4f59\u5206\u6d41\u6982\u7387\u9ad8\u3001PC\u7814\u7a76\u65f6\u95f4\u8fc7\u957f\u8de8\u5ea6\u8d85\u8fc710\u5e74\u3001TIA\u60a3\u8005\u8fc7\u591a\u5bfc\u81f4\u7eb3\u5165\u6807\u51c6\u53ca\u7ec8\u70b9\u4e8b\u4ef6\u8bbe\u8ba1\u4e0d\u4e25\u8c28\u3001\u4e24\u7ec4\u5931\u8bbf\u7387\u8ba1\u7b97\u4e0d\u540c\u7b49\u76f8\u5173\u3002\u53e6\u6709\u4e00\u9879RCT\u76f4\u63a5\u5bf9\u6bd4\u4e86Amplatzer\u3001StarFlex\u548cHelex 3\u79cd\u5c01\u5835\u5668\uff0c\u968f\u8bbf5\u5e74\u7ed3\u679c\u53d1\u73b0\uff0c\u5352\u4e2d\u590d\u53d1\u98ce\u9669\u4e0e\u5c01\u5835\u5668\u6709\u5173\uff0c\u4e0e\u836f\u7269\u6cbb\u7597\u76f8\u6bd4\uff0c\u4f7f\u7528Amplatzer\u5c01\u5835\u5668\u5c01\u5835PFO\u53ef\u4f7f\u5352\u4e2d\u590d\u53d1\u76f8\u5bf9\u5371\u9669\u964d\u4f4e61%\uff0c\u5e76\u660e\u663e\u4f18\u4e8eStarFlex\u548cHelex\u5c01\u5835\u5668\u3002\u56e0\u6b64\uff0c\u63d0\u51fa\u5c01\u5835PFO\u7684\u6709\u6548\u6027\u53d6\u51b3\u4e8e\u6240\u4f7f\u7528\u5c01\u5835\u5668\u7684\u6982\u5ff5\u3002\u968f\u77402015\u5e74RESPECT\u7814\u7a76\u957f\u671f\u968f\u8bbf\u7ed3\u679c\u9633\u6027\u7684\u516c\u5e03, 2016\u5e741\u6708\uff0cFDA\u6700\u7ec8\u6279\u51c6\u4e86 Amplatzer PFO \u5c01\u5835\u5668\u5e94\u7528\u4e8e\u4e34\u5e8a\uff0c\u4f7f\u5f97PFO\u4ecb\u5165\u6cbb\u7597\u7684\u9010\u6e10\u53d7\u8ba4\u53ef\u3002<\/p>\n
2017\u5e749\u6708\uff0c\u65b0\u82f1\u683c\u5170\u6742\u5fd7\u8fde\u7eed\u520a\u767b\u4e86CLOSE\u3001REDUCE \u548c RESPECT \u7814\u7a76\u7684\u8fdc\u671f\u968f\u8bbf\u7ed3\u679c, \u7814\u7a76\u7ed3\u679c\u5747\u63d0\u793a\u5728\u964d\u4f4e\u5352\u4e2d\u590d\u53d1\u98ce\u9669\u65b9\u9762, \u7ecf\u5bfc\u7ba1\u5c01\u5835PFO\u4f18\u4e8e\u5355\u7eaf\u836f\u7269\u6cbb\u7597\uff0c\u6700\u7ec8\u4e3aPFO\u4ecb\u5165\u6cbb\u7597\u5960\u5b9a\u624e\u5b9e\u7684\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u57fa\u7840\u3002CLOSE\u7814\u7a76\u968f\u8bbf\uff085.3\u00b12.0\uff09\u5e74\u53d1\u73b0\uff0c \u5c01\u5835\u7ec4\u5352\u4e2d\u590d\u53d1\u7387\u660e\u663e\u4f4e\u4e8e\u5355\u7eaf\u6297\u8840\u5c0f\u677f\u7ec4\uff08P<0.001\uff09\u3002RESPECT\u7814\u7a76\u7684\u957f\u671f\u968f\u8bbf\u7ed3\u679c\uff08\u4e2d\u4f4d\u968f\u8bbf\u65f6\u95f45.9\u5e74\uff09\u663e\u793a,\u4e0e\u836f\u7269\u6cbb\u7597\u7ec4\u76f8\u6bd4, \u7ecf\u5bfc\u7ba1 PFO\u5c01\u5835\u672f\u540e\u7f3a\u8840\u6027\u5352\u4e2d\u590d\u53d1\u7387\u8f83\u4f4e\uff08P=0.046\uff09\u3002REDUCE\u7814\u7a76\uff08\u4e2d\u4f4d\u968f\u8bbf3.2\u5e74\uff09\u53d1\u73b0\uff0cPFO\u5c01\u5835\u7ec4\u7f3a\u8840\u6027\u5352\u4e2d\u53d1\u751f\u7387\u660e\u663e\u4f4e\u4e8e\u5355\u7eaf\u6297\u8840\u5c0f\u677f\u7ec4\uff08P=0.002\uff09\u3002<\/p>\n
5. \u76f8\u5173\u6307\u5357\u5171\u8bc6\uff1a<\/p>\n
\u5173\u4e8e\u7ecf\u76ae\u5c01\u5835\u672f\u95ed\u5408 PFO \u65b0\u8fd1\u7684\u76f8\u5173\u7684\u6307\u5357\u4e5f\u7ed9\u51fa\u4e86\u5efa\u8bae\u30022018\u5e74\uff0c\u52a0\u62ff\u5927\u6307\u5357\u66f4\u65b0\uff0c\u5c06\u5c01\u5835PFO\u4f5c\u4e3aCS\u60a3\u8005\u7684\u4e8c\u7ea7\u9884\u9632\u7b56\u7565\uff08\u8bc1\u636e\u7ea7\u522bA\uff09\u3002\u968f\u540e\uff0c\u5fb7\u56fd\u6307\u5357\u5c06\u5c01\u5835PFO\u9884\u9632\u5352\u4e2d\u5217\u4e3aIa\u7c7b\u9002\u5e94\u5f81\u30022018\u5e74\uff0c\u4e00\u9879\u53d1\u8868\u5728\u82f1\u56fd\u533b\u5b66\u6742\u5fd7\u4e0a\u7684\u591a\u56fd\u4e13\u5bb6\u5236\u5b9a\u7684\u4e34\u5e8a\u6307\u5357\u5efa\u8bae\uff0c\u5728\u65e0\u7981\u5fcc\u7684\u60c5\u51b5\u4e0b\uff0c\u6240\u6709\u5408\u5e76CS\u768460\u5c81\u4ee5\u4e0bPFO\u60a3\u8005\u53ef\u4ee5\u63a5\u53d7\u7ecf\u5bfc\u7ba1\u5375\u5706\u5b54\u5c01\u5835\u672f,\u672f\u540e\u8fdb\u884c\u6297\u8840\u5c0f\u677f\u6cbb\u7597\u30022020\u5e74, \u7f8e\u56fd\u795e\u7ecf\u79d1\u5b66\u534f\u4f1a\u53d1\u5e03\u7684\u6307\u5357\u300a\u5375\u5706\u5b54\u672a\u95ed\u548c\u7ee7\u53d1\u6027\u5352\u4e2d\u7684\u9884\u9632\u300b\u4e2d\u6307\u51fa\uff0c\u5efa\u8bae\u5bf960\u5c81\u4ee5\u4e0b\uff0c\u6709PFO\u548cCS\u4e14\u672a\u53d1\u73b0\u5176\u4ed6\u4e2d\u98ce\u673a\u5236\u7684\u60a3\u8005,\u5efa\u8bae\u884cPFO\u5c01\u5835\u672f\u3002<\/p>\n
2021\u5e74\u6211\u56fd\u5236\u5b9a\u4e86\u300a\u5375\u5706\u5b54\u672a\u95ed\u76f8\u5173\u5352\u4e2d\u9884\u9632\u4e2d\u56fd\u4e13\u5bb6\u6307\u5357\u300b\u8be5\u6307\u5357\u5efa\u8bae\uff08\u56fe5\uff09:\uff081\uff09\u5e74\u9f8416-60\u5c81, \u8840\u6813\u6813\u585e\u6027\u8111\u6897\u6b7b\u4f34PFO\u60a3\u8005, \u672a\u53d1\u73b0\u5176\u4ed6\u5352\u4e2d\u53d1\u75c5\u673a\u5236\uff0cPFO\u4f34ASA\u6216\u4e2d\u81f3\u5927\u91cfRLS\u6216\u76f4\u5f84\u22652 mm, \u5efa\u8bae\u884c\u7ecf\u5bfc\u7ba1\u5c01\u5835PFO\u672f\uff08I\u7c7b, A \u7ea7\uff09\uff1b\uff082\uff09\u4f20\u7edf\u8840\u7ba1\u98ce\u9669\u56e0\u7d20\uff08\u5982\u9ad8\u8840\u538b\u3001\u7cd6\u5c3f\u75c5\u3001\u9ad8\u8102\u8840\u75c7\u6216\u5438\u70df\u7b49\uff09\u5c11, \u5168\u9762\u8bc4\u4f30\uff08\u5305\u62ec\u957f\u7a0b\u5fc3\u7535\u76d1\u6d4b\u9664\u5916\u623f\u98a4\uff09\u540e\u672a\u53d1\u73b0\u5176\u4ed6\u5352\u4e2d\u673a\u5236\uff0cPFO\u4f34ASA\u3001\u4e2d\u81f3\u5927\u91cfRLS\u6216\u76f4\u5f84\u22652mm\uff0c\u5e74\u9f84>60-65\u5c81\u8005\uff08\u7279\u6b8a\u60c5\u51b5\u5e74\u9f84\u53ef\u4ee5\u9002\u5f53\u653e\u5bbd\uff09, \u5efa\u8bae\u884c\u7ecf\u5bfc\u7ba1 PFO\u5c01\u5835\u672f\uff08IIa\u7c7b,C\u7ea7\uff09;\uff083\uff09\u5e74\u8f7b\u3001\u5355\u4e00\u6df1\u90e8\u5c0f\u6897\u6b7b\uff08\u76f4\u5f84<1. 5 cm\uff09, PFO\u4f34ASA\u3001\u4e2d\u81f3\u5927\u91cfRLS\u6216\u76f4\u5f84\u22652 mm\uff0c\u65e0\u5c0f\u8840\u7ba1\u75be\u75c5\u7684\u5371\u9669\u56e0\u7d20\u5982\u9ad8\u8840\u538b\u3001\u7cd6\u5c3f\u75c5\u6216\u9ad8\u8102\u8840\u75c7\u7b49, \u5efa\u8bae\u884c\u7ecf\u5bfc\u7ba1PFO\u5c01\u5835\u672f, \u4e14\u5e74\u9f84\u53ef\u9002\u5f53\u653e\u5bbd\uff08IIa \u7c7b, C\u7ea7\uff09; \uff084\uff09PFO\u76f8\u5173\u5352\u4e2d,\u5408\u5e76\u660e\u786eDVT\u6216\u80ba\u6813\u585e, \u4e0d\u5177\u5907\u957f\u671f\u6297\u51dd\u6761\u4ef6, \u5efa\u8bae\u884c\u7ecf\u5bfc\u7ba1\u5c01\u5835PFO\u672f\uff08IIa\u7c7b, B\u7ea7\uff09\u3002<\/p>\n
\u7b80\u5355\u800c\u8a00\uff0c\u5bf9\u4e8e\u5408\u5e76\u8111\u6897\u7684PFO\u5c01\u5835\u9002\u5e94\u8bc1\u4e3b\u8981\u8003\u8651\u4e09\u4e2a\u65b9\u9762\uff1a\u2460\u4e34\u5e8a\u5371\u9669\u56e0\u7d20\uff0c\u662f\u5426\u4e3a\u4f20\u7edf\u8111\u6897\u4f4e\u5371\u4eba\u7fa4\uff1a\u5e74\u9f84\u662f\u5426\u5c0f\u4e8e60\u5c81\uff0c\u662f\u5426\u6709\u4f20\u7edf\u8840\u7ba1\u98ce\u9669\u56e0\u7d20\uff1b\u2461\u662f\u5426\u4e3a\u5927\u7684PFO\u6216\u590d\u6742\u6027PFO\uff1aRLS\u22652\u7ea7\uff1bPFO\u76f4\u5f84\u22652 mm\uff1b\u4f34\u6709\u623f\u95f4\u9694\u7624\u3001\u957f\u96a7\u9053\u578b>8mm\u7b49\u590d\u6742\u89e3\u5256\uff1b\u2462\u662f\u5426\u5df2\u6392\u9664\u5176\u4ed6\u8111\u6897\u539f\u56e0\uff0c\u4e34\u5e8a\u8868\u73b0\u53ca\u5934\u9885\u5f71\u50cf\u5b66\u662f\u5426\u7b26\u5408PFO\u5f15\u8d77\u8111\u6897\u7684\u7279\u5f81\u3002<\/p>\n
\u56fe5. \u300a\u5375\u5706\u5b54\u672a\u95ed\u76f8\u5173\u5352\u4e2d\u9884\u9632\u4e2d\u56fd\u4e13\u5bb6\u6307\u5357\uff082021\u5e74\uff09\u300b<\/p>\n
\u56db<\/p>\n
\u504f\u5934\u75db\u5408\u5e76PFO\u7684\u4e34\u5e8a<\/p>\n
\u7814\u7a76\u8bc1\u636e\u53ca\u5c01\u5835\u6307\u5f81<\/p>\n
1.PFO\u4e0e\u504f\u5934\u75db\u7684\u76f8\u5173\u6027<\/p>\n
\u504f\u5934\u75db(migraine)\u662f\u4e34\u5e8a\u5e38\u89c1\u7684\u5934\u75db\u7c7b\u578b\uff0c\u5176\u7279\u70b9\u5305\u62ec\uff1a\u2460\u4e34\u5e8a\u4ee5\u53d1\u4f5c\u6027\u4e2d\u91cd\u5ea6\u3001\u640f\u52a8\u6837\u5934\u75db\uff0c\u2461\u5934\u75db\u591a\u4e3a\u504f\u4fa7\uff0c\u2462\u4e00\u822c\u6301\u7eed4\uff5e72\u5c0f\u65f6\uff0c\u2463\u53ef\u4f34\u6709\u6076\u5fc3\u3001\u5455\u5410\u3001\u754f\u5149\u548c\u754f\u58f0\u7b49\u795e\u7ecf\u53cd\u5c04\u75c7\u72b6\uff0c\u53ef\u6709\u89c6\u89c9\u3001\u611f\u89c9\u969c\u788d\u3001\u8a00\u8bed\u969c\u788d\u7b49\u5148\u5146\u6027\u795e\u7ecf\u75c7\u72b6\uff1b\u2464\u4e0d\u80fd\u5f52\u56e0\u4e8e\u5176\u4ed6\u75be\u75c5\uff0c\u7279\u522b\u662f\u5668\u8d28\u6027\u75be\u75c5\u3002\u5149\u3001\u58f0\u523a\u6fc0\u6216\u65e5\u5e38\u6d3b\u52a8\u5747\u53ef\u52a0\u91cd\u5934\u75db\uff0c\u5b89\u9759\u73af\u5883\u3001\u4f11\u606f\u53ef\u7f13\u89e3\u5934\u75db\u3002\u504f\u5934\u75db\u5728\u513f\u7ae5\u548c\u9752\u5c11\u5e74\u4e2d\u5f88\u5e38\u89c1\u3002\u4eba\u7fa4\u4e2d\u60a3\u75c5\u7387\u4e3a5%\uff5e10%\uff0c\u5e76\u968f\u5e74\u9f84\u589e\u957f\u800c\u589e\u52a0\u3002\u4f5c\u4e3a\u4e00\u79cd\u590d\u6742\u6027\u548c\u591a\u53d8\u6027\u75be\u75c5\uff0c\u76ee\u524d\u504f\u5934\u75db\u7684\u836f\u7269\u6cbb\u7597\u5747\u4e3a\u5bf9\u75c7\u6cbb\u7597\uff0c\u800c\u4e14\u5e76\u975e\u5bf9\u6240\u6709\u60a3\u8005\u5747\u6709\u6548\u3002\u56e0\u6b64\u9700\u8981\u79ef\u6781\u63a2\u7d22\u6709\u6548\u7684\u4e2a\u4f53\u5316\u6cbb\u7597\u65b9\u6cd5\u3002\u6700\u65e9\u5c06PFO\u4e0e\u504f\u5934\u75db\u8054\u7cfb\u5728\u4e00\u8d77\u662f\u57fa\u4e8e\u4ee5\u4e0b\u4e24\u65b9\u9762\u7684\u53d1\u73b0\uff1a\u4e00\u65b9\u9762\u662f\u6d41\u884c\u75c5\u5b66\uff0c\u5373\u504f\u5934\u75db\u60a3\u8005\u4f34\u53d1PFO\u7684\u6bd4\u4f8b\u8f83\u9ad8\uff0c\u65e9\u57281998\u5e74\uff0c\u5c31\u6709\u610f\u5927\u5229\u5b66\u8005\u53d1\u73b0\u5148\u5146\u6027\u504f\u5934\u75db\u60a3\u8005\u4f34\u53d1 PFO\u7684\u6bd4\u4f8b\u660e\u663e\u9ad8\u4e8e\u4e00\u822c\u4eba\u7fa4; \u53e6\u4e00\u65b9\u9762\u5219\u662f\u4e34\u5e8a\u5b9e\u8df5 \uff0c\u5373\u4e00\u4e9b\u56e0\u4e3a\u5352\u4e2d\u800c\u63a5\u53d7\u4e86\u7ecf\u5bfc\u7ba1\u5c01\u5835PFO\u6cbb\u7597\u7684\u60a3\u8005\uff0c\u5728\u5c01\u5835\u6210\u529f\u540e\u53d1\u73b0\u504f\u5934\u75db\u75c7\u72b6\u7f13\u89e3\u751a\u81f3\u6d88\u5931\u4e86\u3002<\/p>\n
2.PFO \u53c2\u4e0e\u504f\u5934\u75db\u53d1\u751f\u7684\u673a\u5236 <\/p>\n
\u8840\u6813\u53cd\u5e38\u6813\u585e\u5b66\u8bf4\uff1a<\/p>\n
\u6b63\u5e38\u60c5\u51b5\u4e0b\uff0c\u5fae\u5c0f\u7684\u9759\u8109\u8840\u51dd\u5757\u6216\u8840\u5c0f\u677f\u805a\u96c6\u4f53\u4f1a\u901a\u8fc7\u80ba\u5faa\u73af\u88ab\u8fc7\u6ee4\u3002\u5982\u6709PFO\u60c5\u51b5\u4e0b\uff0c\u8fd9\u4e9b\u5fae\u5c0f\u6813\u5b50\u4f1a\u7ed5\u8fc7\u80ba\u5faa\u73af\u76f4\u63a5\u8fdb\u5165\u52a8\u8109\uff0c\u5f15\u8d77\u52a8\u8109\u7684\u77ed\u6682\u95ed\u585e,\u5bfc\u81f4\u52a8\u8109\u4f9b\u8840\u533a\u7684\u4f4e\u704c\u6ce8\uff0c\u5bfc\u81f4\u5927\u8111\u4e9a\u4e34\u5e8a\u6897\u6b7b\uff0c\u6210\u4e3a\u504f\u5934\u75db\u7684\u89e6\u53d1\u56e0\u7d20\u3002<\/p>\n
\u8840\u7ba1\u6d3b\u6027\u7269\u8d28\u5b66\u8bf4\uff1a<\/p>\n
\u8840\u7ba1\u6d3b\u6027\u7269\u8d28\uff085-\u7f9f\u8272\u80fa\u3001\u964d\u9499\u7d20\u6e90\u57fa\u56e0\u76f8\u5173\u80bd\u7b49\uff09\u53ef\u4ee5\u4ecb\u5bfc\u4e2d\u67a2\u75db\u89c9\u4fe1\u53f7\u7684\u4f20\u9012\uff0c\u53c2\u4e0e\u504f\u5934\u75db\u53d1\u751f\u7684\u673a\u5236\u3002\u6b63\u5e38\u60c5\u51b5\u4e0b, \u8fd9\u4e9b\u8840\u7ba1\u6d3b\u6027\u7269\u8d28\u4f1a\u88ab\u80ba\u6bdb\u7ec6\u8840\u7ba1\u4e2d\u7684\u5355\u80fa\u6c27\u5316\u9176\u706d\u6d3b\uff0c\u4e0d\u4f1a\u8fdb\u5165\u52a8\u8109\u8840\u3002\u800c PFO\u4f7f\u8fd9\u4e9b\u8840\u7ba1\u6d3b\u6027\u7269\u8d28\u7ed5\u8fc7\u80ba\u5e76\u76f4\u63a5\u9003\u9038\u5230\u5168\u8eab\u5faa\u73af\uff0c\u5728\u8111\u52a8\u8109\u4e2d\u6c89\u79ef\u5230\u4e00\u5b9a\u6d53\u5ea6\u65f6\uff0c\u4e0e\u76f8\u5e94\u7684\u795e\u7ecf\u5143\u53d7\u4f53\u76f8\u7ed3\u5408\u4f5c\u7528\u4e8e\u4e09\u53c9\u795e\u7ecf\u8282\u7ec6\u80de\uff0c\u4ece\u800c\u89e6\u53d1\u504f\u5934\u75db\u3002<\/p>\n
3. \u5faa\u8bc1\u533b\u5b66\u8bc1\u636e <\/p>\n
\u8bb8\u591a\u89c2\u5bdf\u6027\u7814\u7a76\u62a5\u544a\u4e86\u7ecf\u5bfc\u7ba1\u5c01\u5835PFO\u540e\u60a3\u8005\u504f\u5934\u75db\u75c7\u72b6\u5f97\u5230\u6539\u5584\u7684\u7ed3\u679c\u3002\u4f46\u76ee\u524d\u5173\u4e8ePFO\u5c01\u5835\u6cbb\u7597\u504f\u5934\u75db\u76843\u5927RCT\u7ed3\u679c\uff0c\u5305\u62ecMIST\u7814\u7a76\u3001PRIMA\u7814\u7a76\u548cPREMIUM\u7814\u7a76\uff0c\u6309\u7167\u539f\u6765\u8bbe\u8ba1\u4e3b\u8981\u7ec8\u70b9\u5206\u6790\uff0c\u672a\u8fbe\u5230\u7edf\u8ba1\u5b66\u610f\u4e49\uff0c\u4f46\u4e9a\u7ec4\u6216\u8005\u8c03\u6574\u540e\u7684\u5206\u6790\uff0c\u4ecd\u80fd\u663e\u793aPFO\u5c01\u5835\u5bf9\u67d0\u4e9b\u4eba\u7fa4\u504f\u5934\u75db\u6cbb\u7597\u662f\u6709\u6548\u7684\u30022008\u5e74\u516c\u5e03\u7684MIST\u7814\u7a76\u7ecf\u8fc76\u4e2a\u6708\u7684\u968f\u8bbf\u4e3b\u8981\u7ec8\u70b9\u5e76\u672a\u8fbe\u5230\u7814\u7a76\u7ec8\u70b9\uff0c\u4f46\u662f\u5c01\u5835\u7ec4\u60a3\u8005\u7684\u504f\u5934\u75db\u53d1\u4f5c\u5929\u6570\u6709\u6240\u51cf\u5c11\uff0c\u8be5\u7814\u7a76\u9887\u4e3a\u91cd\u8981\u7684\u542f\u793a\u662f\uff0c\u53d1\u73b060%\u7684\u504f\u5934\u75db\u60a3\u8005\u5b58\u5728\u67d0\u79cd\u5f62\u5f0f\u7684RLS\uff0c\u5176\u4e2d38 %\u7684RLS\u662f\u7531PFO\u5f15\u8d77\uff0c\u4f50\u8bc1\u4e86RLS\u53c2\u4e0e\u4e86\u504f\u5934\u75db\u7684\u53d1\u751f\u30022016\u5e74\u516c\u5e03\u7684PRIMA\u7814\u7a76\u7ed3\u679c\u53d1\u73b0\uff0c12\u4e2a\u6708\u968f\u8bbf\u65f6\u5c01\u5835\u7ec4\u5e73\u5747\u6bcf\u6708\u53d1\u4f5c\u504f\u5934\u75db\u7684\u5929\u6570\u8f83\u5bf9\u7167\u7ec4\u51cf\u5c11\u4e861.2 \u5929\uff0c\u4f46\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff1b\u7136\u800c\u5176\u4e2d\u5148\u5146\u6027\u504f\u5934\u75db\u60a3\u8005\u5e73\u5747\u6bcf\u6708\u53d1\u4f5c\u7684\u5929\u6570\u8f83\u5bf9\u7167\u7ec4\u660e\u663e\u51cf\u5c11\uff0c\u800c\u4e14\u5148\u5146\u6027\u504f\u5934\u75db\u7684\u53d1\u4f5c\u6b21\u6570\u4e5f\u663e\u8457\u51cf\u5c11\u30022017\u5e74\u53d1\u8868\u7684PREMIUM\u7814\u7a76\uff0c\u6ca1\u6709\u5c01\u5835\u7ec4\u504f\u5934\u75db\u53d1\u751f\u7387\u51cf\u5c115 0% \u8fd9\u4e00\u4e3b\u8981\u7814\u7a76\u7ec8\u70b9\u4e3a\u663e\u793a\u4f18\u52bf\uff0c\u4f46\u548c\u5bf9\u7167\u7ec4\u76f8\u6bd4\uff0c\u5c01\u5835\u7ec4\u60a3\u8005\u6bcf\u5e74\u53d1\u4f5c\u504f\u5934\u75db\u7684\u5929\u6570\u51cf\u5c11\uff0c\u504f\u5934\u75db\u7684\u5b8c\u5168\u7f13\u89e3\u7387\u4e5f\u66f4\u9ad8\u3002\u5728\u5bf9\u51e0\u4e2aRCT\u7ed3\u679c\u7684\u6b21\u8981\u7814\u7a76\u7ec8\u70b9\u8fdb\u884c\u835f\u8403\u5206\u6790\u540e\u53d1\u73b0\uff0c\u5c01\u5835\u7ec4\u504f\u5934\u75db\u53d1\u4f5c\u9891\u7387\u548c\u6301\u7eed\u65f6\u95f4\u663e\u8457\u964d\u4f4e\uff1b\u4e0e\u836f\u7269\u6cbb\u7597\u7ec4\u76f8\u6bd4\uff0c\u6709\u5148\u5146\u75c7\u72b6\u7684\u60a3\u8005\u6216\u6709\u8111\u8840\u7ba1\u75c5\u53f2\u7684\u60a3\u8005\u5728\u63a5\u53d7\u5c01\u5835\u6cbb\u7597\u540e\uff0c\u5934\u75db\u75c7\u72b6\u6539\u5584\u7684\u5dee\u5f02\u5177\u6709\u7edf\u8ba1\u5b66\u610f\u4e49\u3002<\/p>\n
\u6709\u5206\u6790\u8ba4\u4e3a\uff0c3\u5927RCT\u7814\u7a76\u4e4b\u6240\u4ee5\u6ca1\u6709\u5f97\u51fa\u9633\u6027\u7ed3\u8bba\uff0c\u53ef\u80fd\u4e0e\u5165\u9009\u60a3\u8005\u504f\u5934\u75db\u7684\u57fa\u7ebf\u53d1\u4f5c\u9891\u7387\u8f83\u4f4e\u3001\u4e3b\u8981\u7814\u7a76\u7ec8\u70b9\u7684\u8bbe\u5b9a\u4e0d\u591f\u79d1\u5b66\uff0c\u7f3a\u4e4f\u4e00\u81f4\u7684\u6807\u51c6\uff0c\u4ee5\u53ca\u5c01\u5835\u672f\u540e\u6ca1\u6709\u5145\u5206\u8bc4\u4f30\u6b8b\u4f59RLS\u7b49\u56e0\u7d20\u6709\u5173\uff0c\u4e5f\u53ef\u80fd\u548c\u90e8\u5206\u5668\u68b0\u672c\u8eab\u53ef\u5bfc\u81f4\u5fae\u8840\u6813\u6709\u5173\u3002\u6211\u4eec\u591a\u5e74\u7684\u4e34\u5e8a\u5b9e\u8df5\u663e\u793a\uff0c\u5bf9\u4e8e\u5408\u9002\u7684\u504f\u5934\u75db\u60a3\u8005\uff0c\u4ecb\u5165\u5c01\u5835\u80fd\u660e\u663e\u7f13\u89e3\u60a3\u8005\u504f\u5934\u75db\u53d1\u751f\u3002\u6839\u636e\u73b0\u6709\u7684\u8bc1\u636e\u63d0\u793a\uff0c\u5bf9\u4e8e\u5408\u5e76PFO\u7684\u504f\u5934\u75db\u60a3\u8005\uff0c\u5982\u679c\u6709\u5148\u5146\u75c7\u72b6\uff0c\u6216\u8005\u65e2\u5f80\u6709\u5352\u4e2d\u75c5\u53f2\uff0c\u63a5\u53d7PFO\u5c01\u5835\u540e\u75c7\u72b6\u6539\u5584\u66f4\u4e3a\u660e\u663e\u3002\u7531\u4e8e\u7f3a\u4e4f\u8db3\u591f\u9ad8\u8d28\u91cf\u7814\u7a76\u7684\u652f\u6301\uff0c\u76ee\u524d\u6307\u5357\u5927\u591a\u6570\u672a\u5bf9PFO\u5408\u5e76\u504f\u5934\u75db\u7684\u4ecb\u5165\u5c01\u5835\u8fdb\u884c\u63a8\u8350\u3002\u4ec5\u6709\u6b27\u6d32\u533b\u5b66\u4f1a2019\u5e74\u64b0\u5199\u7684\u300aPFO\u60a3\u8005\u7ba1\u7406\u6b27\u6d32\u5171\u8bc6\u300b\u4e2d\uff0c\u5bf9\u5305\u62ec\u7ecf\u5bfc\u7ba1\u5c01\u5835PFO\u5728\u5185\u7684\u504f\u5934\u75db\u6cbb\u7597\u6d41\u7a0b\u7ed9\u51fa\u4e86\u5efa\u8bae\uff08\u56fe6\uff09\u3002\u53ef\u4ee5\u770b\u51fa\uff0c\u4f55\u65f6\u91c7\u7528\u5c01\u5835PFO\u6765\u6cbb\u7597\u504f\u5934\u75db\uff0c\u4e3b\u8981\u53d6\u51b3\u4e8e\u6709\u65e0\u5148\u5146\u75c7\u72b6\u3001\u5352\u4e2d\u75c5\u53f2\u3001\u5bf9\u836f\u7269\u6cbb\u7597\u7684\u53cd\u5e94\u4ee5\u53ca\u60a3\u8005\u7684\u610f\u613f\uff0c\u800c\u4e0ePFO\u7684\u89e3\u5256\u7279\u5f81\u5e76\u65e0\u76f8\u5173\u6027\u3002 <\/p>\n
\u56fe6. \u300a2019 \u5e74PFO\u60a3\u8005\u7ba1\u7406\u6b27\u6d32\u5171\u8bc6\u300b\u504f\u5934\u75db\u60a3\u8005\u7ba1\u7406\u6d41\u7a0b<\/p>\n
\u4e94<\/p>\n
\u603b\u7ed3\u53ca\u5c55\u671b<\/p>\n
PFO\u662f\u4e00\u79cd\u5e38\u89c1\u7684\u5fc3\u810f\u75be\u75c5\uff0c\u660e\u663e\u5f71\u54cd\u7740\u4eba\u7c7b\u7684\u5065\u5eb7\u3002\u4ece\u6700\u65e9\u76841877\u5e74\u5fb7\u56fd\u75c5\u7406\u5b66\u5bb6 Cohnheim\u53d1\u73b0\u53cd\u5e38\u6813\u585e\u5f00\u59cb\uff0c\u5230\u76ee\u524d\u56fd\u5185\u5916\u7ecf\u5bfc\u7ba1\u5c01\u5835 PFO \u9884\u9632\u5352\u4e2d\u548c\u504f\u5934\u75db\u90fd\u7ecf\u5386\u4e86\u4e00\u6ce2\u4e09\u6298\u7684\u53d1\u5c55\u8fc7\u7a0b\u3002\u4ece\u65e9\u671f\u7684RCT\u7814\u7a76\u4e0d\u652f\u6301\u5c01\u5835\u6cbb\u7597PFO\uff0c\u76f4\u81f3\u8fd1\u671f\u56fd\u5185\u5916\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u7684\u4e0d\u65ad\u63a8\u9648\u51fa\u65b0, \u5c24\u5176\u662f\u300a\u5375\u5706\u5b54\u672a\u95ed\u76f8\u5173\u5352\u4e2d\u9884\u9632\u4e2d\u56fd\u4e13\u5bb6\u6307\u5357\u300b\u7684\u63a8\u51fa, \u4e3a\u6211\u56fdPFO\u7684\u89c4\u8303\u5316\u6cbb\u7597\u63d0\u51fa\u4e86\u660e\u786e\u5efa\u8bae\u3002<\/p>\n
\u672c\u6587\u5bf9\u7ecf\u5bfc\u7ba1\u5c01\u5835PFO\u9884\u9632\u5352\u4e2d\u548c\u504f\u5934\u75db\u7684\u6d41\u884c\u75c5\u5b66\u3001\u53d1\u75c5\u673a\u5236\u3001\u8bca\u65ad\u65b9\u6cd5\u3001\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u548c\u56fd\u5185\u5916\u6307\u5357\u7684\u53d8\u8fc1\u8fdb\u884c\u7b80\u5355\u4ecb\u7ecd\u3002\u521b\u5efa\u4ee5\u60a3\u8005\u4e3a\u4e2d\u5fc3MDT\u6a21\u5f0f\uff0c\u52a0\u5f3a\u4e0e\u795e\u7ecf\u5185\u79d1\u3001\u8d85\u58f0\u7684\u534f\u4f5c\uff0c\u7b5b\u67e5\u51fa\u9ad8\u5371PFO\u60a3\u8005, \u9009\u62e9\u5408\u7406\u7684\u6cbb\u7597\u65b9\u6848, \u4fc3\u8fdbPFO\u4ecb\u5165\u5c01\u5835\u6280\u672f\u66f4\u52a0\u89c4\u8303\u3001\u6301\u7eed\u3001\u5065\u5eb7\u53d1\u5c55\uff0c\u662f\u672a\u6765\u6211\u56fdPFO\u60a3\u8005\u7ba1\u7406\u7684\u53d1\u5c55\u65b9\u5411\u3002<\/p>\n
\u53c2\u8003\u6587\u732e\uff1a<\/p>\n
1.\u4e2d\u56fd\u533b\u5e08\u534f\u4f1a\u5fc3\u8840\u7ba1\u5185\u79d1\u533b\u5e08\u5206\u4f1a\u3002\u5375\u5706\u5b54\u672a\u95ed\u5904\u7406\u7b56\u7565\u4e2d\u56fd\u4e13\u5bb6\u5efa\u8bae [ J] \u3002\u5fc3\u810f\u6742\u5fd7, 2015, 27: 373- 379\u3002<\/p>\n
2.\u4e2d\u534e\u533b\u5b66\u4f1a\u5fc3\u8840\u7ba1\u5185\u79d1\u5206\u4f1a, \u4e2d\u56fd\u533b\u5e08\u534f\u4f1a\u5fc3\u8840\u7ba1\u5185\u79d1\u5206\u4f1a\u3002\u5375\u5706\u5b54\u672a\u95ed\u9884\u9632\u6027\u5c01\u5835\u672f\u4e2d\u56fd\u4e13\u5bb6\u5171\u8bc6 [J]. \u5fc3\u810f\u6742\u5fd7, 2015, 32: 209- 214\u3002<\/p>\n
3.\u5f20\u7389\u987a, \u848b\u4e16\u826f, \u6731\u9c9c\u9633, \u7b49\u3002\u5375\u5706\u5b54\u672a\u95ed\u76f8\u5173\u5352\u4e2d\u9884\u9632\u4e2d\u56fd\u4e13\u5bb6\u6307\u5357 [ J] \u3002\u5fc3\u810f\u6742\u5fd7, 2021, 33: 1- 10.<\/p>\n
4.Pristipino C\uff0cSievert H\uff0cD’Ascenzo F\uff0cet al. European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism. Eur Heart J\uff0c2019\uff0c40(38):3182-3195.<\/p>\n
\u672c\u6587\u4f9b\u7a3f\uff1a\u6f58\u6587\u5fd7<\/p>\n
\u672c\u6587\u7f16\u8f91\uff1a\u80e1\u5609\u7984<\/p>\n
#artContent h1#artContent p img#artContent table<\/p>\n","protected":false},"excerpt":{"rendered":"
\u672c\u6587\u4f5c\u8005\uff1a\u5f20\u5cf0 \u6f58\u6587\u5fd7 \u5468\u8fbe\u65b0 &nbs … \u7ee7\u7eed\u9605\u8bfb