国产封堵器治疗巨大动脉导管未闭伴重度肺动脉高压的疗效观察  

Effect observation of domestic-made occluder on treating huge patent ductus arteriosus complicated with severe pulmonary arterial hypertension

作　　者：王树伟[1] 秦风义 陈良金 史臻 张浩[2] WANG Shuwei;QIN Fengyi;CHEN Liangjin;SHI Zhen;ZHANG Hao(Department of Cardiothoracic Surgery;Department of Cardiovascular Medicine,The 153 rd Hospital of People′s Liberation Army,Zhengzhou,Henan,450042)

机构地区：[1]解放军第153中心医院心血管外科,河南郑州450042 [2]解放军第153中心医院心血管内科,河南郑州450042

出　　处：《实用临床医药杂志》2018年第22期5-7,共3页Journal of Clinical Medicine in Practice

摘　　要：目的观察国产封堵器治疗巨大动脉导管未闭(PDA)伴重度肺动脉高压(PAH)的效果。方法选取巨大PDA伴重度PAH患者4例。所有患者术前均经心脏彩超明确诊断。3例成人患者入院后给予降低肺动脉压力、纠正心衰治疗1周以上。所有患者均经导管造影测量PDA直径,并据此选用国产PDA封堵器。封堵试验前后检测主动脉、肺动脉压力,封堵试验阳性后释放PDA封堵器。结果 4例患者封堵试验均为阳性并封堵成功。所有患者术后心前区杂音均消失,心脏彩超提示分流消失,封堵器位置无变化。术后随访时间15～34个月,复查心脏彩超均未见分流,无封堵器移位及脱落。结论采用国产封堵器并依据术中封堵试验标准对巨大PDA伴重度PAH患者治疗效果良好。Objective To observe the therapeutic effect of domestic-made occluder on the treatment of huge patent ductus arteriosus （PDA） complicated with severe pulmonary arterial hypertension （PAH）. Methods Four patients with huge PDA and severe PAH were diagnosed by echocardiography. Three adult patients received conventional treatment of heart failure and PAH for more than a week after hospital admission. The domestic-made PDA occluder were customized according to the results of preoperational echocardiography. The aortic and pulmonary artery pressure was detected before and after occlusion test, and the PDA occluder was released after positive occlusion test. Results The trans-catheter closure testing was positive in 4 patients and the PDA occluders were released successfully. The precardiac murmur disappeared in all patients, the shunt disappeared and the position of occluder remained unchanged. Follow up time was 15 to 34 months after operation. No shunt was found in cardiac color Doppler ultrasound. No occluder was removed. Conclusion Domestic occluder in accordance with standard of intraoperative occlusion has better clinical efficacy for giant PDA patients with severe PAH.

关 键 词：动脉导管未闭 肺动脉高压 封堵器 封堵试验 

分 类 号：R542.5[医药卫生—心血管疾病]