经导管封堵外科开胸术后再通动脉导管未闭的临床分析  

Clinical analysis of transcatheter closure of recanalized patent ductus arteriosus after surgical operation

作　　者：陈晓彬[1] 蒲晓群[1] 杨天伦[1] 郑昭芬[1] 李传昶[1] 邓金华[1] 孟霜媛[1] 

机构地区：[1]中南大学湘雅医院心内科,湖南长沙410008

出　　处：《中国医学工程》2007年第9期770-772,共3页China Medical Engineering

摘　　要：目的分析研究动脉导管未闭(patent ductusarteriosus,PDA)外科开胸术后再通患者行介入封堵治疗的可行性、安全性及疗效。方法回顾分析2002年～2006年该院PDA介入封堵治疗的患者216例,其中系动脉导管未闭外科开胸术后再通患者8(男3,女5)例,占3.7%。该组中年龄3～35岁,平均(11.8±8.5)岁,再通的动脉导管最窄处直径1.5～4.0mm,采用COOK可控弹簧圈或国产PDA蘑菇伞经导管封堵再通的PDA,术后24h、1、3、6个月和1年随访,复查心电图、超声心动图。结果8例PDA外科开胸术后再通患者均一次介入封堵成功,介入手术成功率100%。其中应用弹簧圈封堵3例,应用国产PDA蘑菇伞封堵5例。手术时间为25～44min,平均(34.3±6.7)min,X线透视时间为4～9min,平均(6.6±2.1)min。术后定期随访,患者PDA残余漏消失,心脏大小恢复正常,无并发症。结论PDA外科开胸术后再通患者行介入封堵治疗是可行、有效、安全的,可以作为外科术后再通的PDA患者的首选治疗方法。[Objective] To analyze the feasibility, safety and efficiency of transcatheter closure of recanalized patent ductus arteriosus （PDA） after surgical operation. [Methods] Retrospective analysis of 216 cases of patent ductus arteriosus after transcatheter closure in our hospital from 2002 to 2006 was carried out, and there were 8 cases of recanalized PDA after surgical operation among them （3.7%）, 3 male and 5 femal, aged from 3 to 35[average （11.8±8.5）]years old. The minimum diameter of recanalized PDA ranged from 1.5 to 4.0mm. 8 patients underwent transcatheter Closure of recanalized PDA using Cook coil or duct occluder. Follow up with ECG and echocardiograph after 24 hours, 1, 3, 6 month and 1 year. [Results] All 8 cases of recanalized PDA underwent transcatheter closure successfully. The technical success rate was 100%. 3 coils and 5 duct occluders were used. The mean time of the procedure was （34.3±6.7） （25-44） minutes, and the mean exposure time to X ray was （6.6±2.1） （4-9） minutes. At a follow-up regularly there were no residual shut and complications, heart became normer. [Conclussion] Transcatheter closure was feasible, effective and safety for patients with recanalized PDA after surgical operation. It may be the best treatment method for these patients.

关 键 词：动脉导管未闭 再通 封堵 

分 类 号：R459.2[医药卫生—治疗学] R543.5[医药卫生—临床医学]