成人动脉导管未闭经介入封堵治疗100例临床分析  

Transcatheter intervention occlusion for patent ductus arteriosus in adults:a clinical analysis of 100 cases

作　　者：郑红艳[1] 魏钟海[1] 宋杰[1] 马冬辉[1] Zheng Hongyan;Wei Zhonghai;Song Jie;Ma Donghui(Department of Cardiovascular Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China)

机构地区：[1]南京大学医学院附属鼓楼医院心内科,210008

出　　处：《中国心血管杂志》2020年第3期226-230,共5页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨成人动脉导管未闭(PDA)经介入封堵治疗的近中期临床疗效。方法回顾性分析2006年4月至2018年12月南京大学医学院附属鼓楼医院共100例成年PDA患者接受介入封堵治疗的临床资料,收集患者的基本信息、临床症状、封堵前各项检查结果(主要是超声心动图)。术后通过门诊或电话规律随访至少6个月,获得患者的临床情况及复查超声心动图结果。结果本组100例成人PDA均封堵成功。在介入封堵PDA后即刻,患者的肺动脉收缩压和舒张压均较术前显著下降[封堵后即刻比术前:(37.25±15.93)mmHg比(47.85±23.22)mmHg,t=8.791,P<0.0001;(18.37±9.98)mmHg比(23.04±11.48)mmHg,t=5.702,P<0.0001],在住院期间均未出现严重手术相关并发症。随访中期疗效,与封堵前比较,超声心动图测量的肺动脉收缩压下降[随访中期比封堵前:(33.72±15.64)mmHg比(42.92±22.28)mmHg,t=6.773,P<0.0001],左室射血分数升高(随访中期比封堵前:57.70%±5.10%比56.09%±6.35%,t=-4.522,P<0.0001),二尖瓣、三尖瓣反流情况改善(Z=-3.411,P=0.001;Z=-4.426,P<0.0001)。结论对于符合介入封堵适应证的成年PDA患者,可通过介入治疗闭合PDA,具有良好的临床获益。Objective To investigate the short-and medium-term clinical outcomes of interventional closure of patent ductus arteriosus(PDA)in adults.Methods The clinical data of 100 PDA patients underwent percutaneous intervention in Nanjing Drum Tower Hospital from April of 2006 to December of 2018 were retrospectively analyzed.The basic information,clinical symptoms and examination results(mainly echocardiographic data)were collected.The patients were followed up by clinic or telephone at least 6 months after surgery.Clinical outcomes and echocardiographic data were re-evaluated.Results All 100 adult PDAs in this group were successfully occluded.Compared with pre-operation,the systolic and diastolic blood pressure of pulmonary artery decreased significantly after transcatheter closure of PDA[(37.25±15.93)mmHg vs.(47.85±23.22)mmHg,t=8.791,P<0.0001;(18.37±9.98)mmHg vs.(23.04±11.48)mmHg,t=5.702,P<0.0001].There were no serious operative complications in all patients during perioperative period.Compared with pre-operation,the pulmonary artery pressure decreased[(33.72±15.64)mmHg vs.(42.92±22.28)mmHg,t=6.773,P<0.0001],ejection fraction increased(57.70%±5.10%vs.56.09%±6.35%,t=-4.522,P<0.0001)and valvular regurgitation improved(Z=-3.411,P=0.001;Z=-4.426,P<0.0001)in middle-term follow-up.Conclusions For adult patients with PDA,who accordance to the indications of interventional closure of PDA,may be beneficial from surgery and have better clinical outcomes.

关 键 词：动脉导管未闭 成年人 介入封堵 肺动脉压 

分 类 号：R54[医药卫生—心血管疾病]