国产Amplatzer蘑菇伞介入治疗中老年动脉导管未闭的近中期疗效分析  

The Short and Intermediate Term Efficacy of Transcatheter Closure by Homemade Amplatzer Mushroom Occluder of Patent Ductus Arteriosus for the Middle-aged or Geratic Patients

作　　者：谢渡江[1] 周陵[1] 李小波[1] 张幼祥[2] 王蓉[1] 陈绍良[1] 

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)心内科,江苏南京210006 [2]南京医科大学附属南京医院(南京市第一医院)心血管超声科,江苏南京210006

出　　处：《现代生物医学进展》2014年第19期3703-3705,3778,共4页Progress in Modern Biomedicine

摘　　要：目的:评价国产Amplatzer蘑菇伞介入治疗中老年动脉导管未闭(patent ductus arteriosus,PDA)的近中期临床疗效及安全性。方法:选择2007年1月至2011年12月我院收治的32例中老年PDA患者,经临床、心电图、X线及经胸超声心动图(TTE)检查确诊,均成功行介入治疗。术后行心电图、X线胸片、TTE随访。结果:32例均1次封堵成功,成功率100%。无重要并发症发生。随访X线胸片显示肺血较术前减少,心胸比率不同程度缩小。术后48小时(32例)超声心动图显示左房内径(LAD)、左室舒张末内径(LVDd)及肺动脉收缩压(PASP)较封堵前明显缩小(P<0.01);术后1、3、6月(32例)超声心动图随访显示LAD及LVDd、PASP进一步缩小;术后1年(30例)、术后2年(20例)、术后3年(12例)、术后4年(5例)超声心动图随访显示心脏大小及肺动脉收缩压恢复正常。结论:国产Amplatzer蘑菇伞介入治疗中老年PDA具有操作简单、创伤小、安全且技术成功率高、住院时间短等优点,近中期疗效明确,并发症少。Objective： To evaluate the short and intermediate term efficacy as well as safety of transcatheter closure by homemade Amplatzer mushroom occluder of patent ductus arteriosus in the treatment of middle-aged or geratic patients. Methods： 32 cases with PDA who were confirmed by clinical manifestation, electrocardiogram （ECG）, X-ray fluoroscopy, transthoracic color Doppler echocardiography （TTE） from January 2007 to December 2011 were selected and received the transcatheter occlusion. Then the follow-ups were conducted. Results： 32 cases were all successfully occluded with the rate of 100%. In follow-ups, X-ray fluoroscopy showed pulmonary venous pleonaemia reduced and cardio-thoracic ration decreased. After 48 hours, the LAD, LVDd and PASP reduced obviously （P〈0.01）; after 1 year （30 cases）, 2 years （20 cases）, 3 years （12 cases） and 4 years （5 cases）. There was no death, complication or therapy. Conclusion： Transcatheter closure of PDA in middle-aged or geratic patients using the homemade Amplatzer mushroom occluder was safety and efficacy with easy procedure, less complication, high successful rate and shorter hospitalization.

关 键 词：动脉导管未闭 介入治疗 中老年 近中期疗效 国产封堵器 

分 类 号：R541.1[医药卫生—心血管疾病]