经胸超声心动图指导动脉导管未闭封堵治疗  

The Transcatheter Closure of PDA Guided by Transthoracic Echocardiography

作　　者：刘庆春[1,2] 肖建民[1,3] 杨帆[1,2] 王杰英[1,3] 马业新[4] 

机构地区：[1]暨南大学附属东莞医院 [2]东莞市太平人民医院超声科,广东省东莞市523000 [3]东莞市太平人民医院心内科,广东省东莞市523000 [4]华中科技大学同济医学院附属同济医院心内科

出　　处：《中国超声医学杂志》2013年第12期1124-1127,共4页Chinese Journal of Ultrasound in Medicine

基　　金：东莞市科技计划重点项目(No.2011105102001)

摘　　要：目的 评价经胸超声心动图指导动脉导管未闭（PDA）封堵治疗的效果.方法 总结PDA封堵治疗患者58例,按经胸超声心动图（TTE）和经主动脉造影（TAA）检查及指导治疗的不同,分为TTE组和TAA组.对两组封堵成功率及相关情况进行比较.结果 TTE组和TAA组PDA直径分别为4.2±1.4 mm （2.2～8.2 mm） vs3.8±1.3 mm （2.0～7.8 mm）;所植入封堵器大小为12±6 mm vs 12±4 mm;手术技术成功率98.2％ vs 100％;微～少量残余分流发生率即刻为4.6％ vs6.6％,随访3～6个月均未见残余分流;两组相比均无统计学差异（P＞0.05）.但手术操作时间和平均住院时间TTE组短于TAA组（P＜0.05）,对比剂用量和X线曝光量及费用TTE组显著小于TAA组（P＜0.001）.结论 经胸超声心动图指导动脉导管未闭封堵治疗具有操作简便安全、技术成功率高,且创伤小、费用低等优点.Objective To evaluate the efficiency in transcatheter closure of Patent ductus arteriosus （PDA） guided by transthoracic eehocardiography（TTE）. Methods We analysed the outcome of 58 patients with PDA who underwent percutaneous transcatheter closure of PDA with Arnplatzer PDA occluder. According to the guidance method in closure procedures, the patients were divided into two groups, TTE group guided by TTE and TAA group guided by transaortic angiography. There are 43 patients in TTE group（29 male and 14 female,age 13±11 years old） ,and 15 patients in TAA group（8 male and 7 female, age 18＋ 14 years old）. The procedure successful rate and other related conditions were compared between the two groups. Results There were no significant differences between the TTE and TAA group in the PDA diarneter（4.24- 1.4 rnrn vs 3.8± 1.3 mm）, the size of implanted oceluder （ 12 ± 6 vs 12 ±4 mm）, the rates of successful closure of PDA（98.2% vs 100%）, and trivial to small residual shunting immediately （4.6% vs 6.6%） or during follow-up 3-6 months（P〉0.05）. But the operating time of closure procedures,the average time of hospital stays were significantly shorter in TTE than those in TAA group（P（0.05）. The injection volume of contrast medium, the quantity of X-ray exposure and the expenses were significantly smaller in TTE than those in TAA group （P〈0. 001）. Conclusions Compared with guidance by TAA, transcatheter closure of PDA under the guidance of TTE is efficient,safe and with the advantage of lower damage and cost.

关 键 词：动脉导管未闭 超声心动图 封堵 

分 类 号：R541.1[医药卫生—心血管疾病]