动脉导管未闭患者行介入封堵治疗的临床观察  

作　　者：余忠琴[1] 朱辉银[1] 李涛[1] 肖玉[1] 张勇[1] 席世兵[1] 

机构地区：[1]湖北医药学院附属太和医院儿童医疗中心,442000

出　　处：《浙江临床医学》2016年第1期58-59,共2页Zhejiang Clinical Medical Journal

摘　　要：目的观察动脉导管未闭（PDA）患者行介入封堵术的临床效果。方法动脉导管未闭患者178例，经临床及经胸超声心动图（TTE）确诊，并行左右心导管、主动脉弓降部造影检查，应用经皮动脉导管未闭介入封堵术治疗[方法：蘑菇伞封堵法、弹簧栓法、Amplatzer第二代封堵器（ADO—II）封堵法]，术后即刻行主动脉弓降部造影和经胸超声心动图检查观察疗效，术后ld、1个月、3个月、6个月、1年行经胸超声心动图、x线胸片、心电图随访观察。结果经皮动脉导管未闭介入封堵成功率98．9％。失败原因：大型PDAl例，伴重度肺动脉高压放置封堵器后血压下降1例。并发症：术后1h封堵器脱落l例，降主动脉血流速度增快1例，左肺动脉血流速度增快1例，溶血1例。结论经皮动脉导管未闭介入封堵治疗创伤小，操作安全，并发症低，在适应证范围内可以替代外科治疗。Objectives To summarize the experience oftarnscatheter closure of patent ductus arteriosus（PDA） with occluder in 178 patients, and to retrospectively explore the follow-up analysis. Methods For the 178 patients with PDA confirmed by clinical examination and transthoracic echocardiography（TTE）, use left and right heart catheter, aortic arch angiography, take percutaneous tarnscatheter closure of patent ductus arteriosus, three methods were applied, which were Amplatzer method, Cook coil method and ADO-II method. Aortic arch angiography and TTE were used immediately after surgery to assess the effect. TTE, chest X-ray and electrocardiogram（EEG） examination were used in follow-up study at I day, 1 months, 6 months, 1 year respectively. Result The successful rate was 98.9%. The causes for procedural failure included large shaped PDA（1 patient）, complicated severe pulmonary hypertension and hypotension after device implantation（1 patient）. Complication 1 patient had device embolization, 1 patient had increased aortic blood flow velocities, 1 patient had left pulmonary artery blood flow velocities increased, 1 patient had hemolyses. Conclusions Percutaneous tarnscatheter closure of PDA has the advantages of less injury, less complications, high successful rate and effective alternative to surgical repair.

关 键 词：动脉导管未闭 介入封堵 随访 

分 类 号：R654.2[医药卫生—外科学]