对比经导管介入与经胸小切口封堵术治疗小儿动脉导管未闭的有效性与安全性  

Contrastive study on the efficacy and safety between transcatheter patent ductus arteriosus closure and mi- ni-incision transthoracic occlusion in children

作　　者：潘筱[1] 

机构地区：[1]临沂市人民医院小儿内科,276003

出　　处：《中华实用儿科临床杂志》2014年第23期1793-1795,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的 探讨经导管介入与经胸小切口封堵治疗小儿动脉导管未闭（PDA），对比2种方法的有效性及安全性。方法 选择临沂市人民医院小儿内科2009年1月至2013年11月经导管介入治疗的PDA 患儿175例（导管介入组），年龄3个月～14岁，使用介入器材除弹簧圈外，均为国产封堵器。与同期临沂市人民医院心外科经胸小切口封堵治疗患儿157例（小切口组，年龄5个月 ～14岁，使用的封堵器与导管介入组相同）比较，分析其疗效及并发症，并行统计学处理。结果 导管介入组175例患儿中，介入成功171例，技术总成功率为97.71% ，无死亡病例，出现并发症8例，并发症发生率为4.57% ；经胸小切口组157例患儿中，封堵成功137例，技术总成功率87.26% ，死亡1例，出现并发症21例，并发症发生率为13.38 % 。导管介入组的成功率明显高于小切口组（χ^2=8.05，P 〈0.01）；导管介入组的并发症发生率明显低于小切口组（χ^2=13.48，P 〈0.01）；且导管介入组的术中失血量、手术时间、住院时间和住院费用均明显低于小切口组［（0.021±0.007）L比（0.088±0.027）L、（36.81 ± 7.19）min比（88.65 ±27.92）min、（4.16 ±0.45）d比（10.68 ±2.38）d、（27943.6±2754.1）元比（35037.4±8659.2）元］，2组各项指标比较差异均有统计学意义（t=29.23、22.19、33.44、18.47，P均〈0.01）。结论 经导管介入治疗PDA并发症少，疗效高，明显优于经胸小切口封堵术，是小儿PDA首选的治疗方法。Objective To evaluate efficacy and safety of transcatheter patent ductus arteriosus（PDA） closure compared with mini-incision transthoracic occlusion in children. Methods The safety and complications of 175 patients who underwent transcatheter closure（ transcatheter group） hospitalized in Department of Pediatrics, Linyi People＇s Hospital were analyzed, the ages ranging from 3 months to 14 years, and the material used was Chinese homemade occluder except for the spring coil. Compared with the 157 patients who underwent mini-incision transthoracic occlusion （mini-incision group） hospitalized in Department of Heart Surgery, Linyi People＇s Hospital from Jan. 2009 to Nov. 2013, the ages ranging from 5 months to 14 years, the material used was same as the transcatheter group. Acquired data was processed through statistics. Results One hundred and seventy-one of the 175 patients achieved success in the transcatheter group,technically success rate was 97.71%, there were 8 patients with complications, but no death, the occurrence rate of complications was 4.57% ;however, 137 of 157 patients achieved success in the mini-incision group, technically success rate was 87.26%, there were 21 patients with complications and 1 death, the occurrence rate of complications was 13.38%. Success rate of the transcatheter group was much higher than the mini-incision group（χ^2 = 8.05 ,P 〈 0.01 ） ,while complications of the transcatheter group was significantly less than the mini-incision group（χ^2 = 13.48, P 〈 0.01 ）, and also the transcatheter group had less hemorrhage during operation, shorter operation time, shorter hospital stay and less hospital expenses compared with the mini-incision group [ （0. 021 ± 0. 007 ） L vs （0. 088 ± 0.027） L,（36.81± 7.19） minvs （88.65 ±27.92） min,（4.16 ±0.45） dvs （10.68 ±2.38） d,（27 943.6± 2 754. 1） RMB vs （35 037.4 ±8 659.2） RMB;t =29.23,22.19,33.44,18.47,all P 〈0.01]. Conclusions Transeatheter PDA elosure in children is better than mi

关 键 词：儿童 动脉导管未闭 经导管介入 外科经胸封堵 小切口 

分 类 号：R726.5[医药卫生—儿科]