动脉导管未闭术后残余分流临床治疗经验  

Clinical experience in the treatment of residual patent ductus arteriosus

作　　者：吕震宇[1] 金梅[1] 王霄芳[1] 郭保静[1] 王志远[1] 杨一妃 LV Zhenyu;JIN Mei;WANG Xiaofang;GUO Baojing;WANG Zhiyuan;YANG Yifei(Pediatric Cardiac Center,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所小儿心脏中心,100029

出　　处：《心肺血管病杂志》2020年第12期1478-1481,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:动脉导管未闭残余分流(rPDAs)是外科结扎及介入治疗术后常见并发症之一,本研究探讨此类并发症再次行介入治疗的效果。方法:2009年1月至2019年12月,共39例rPDAs患者(外科结扎术后38例,介入治疗术后l例)施行了经导管封堵术,其中男性12例,女性27例,中位年龄17(5,33)岁,初次手术关闭后经导管干预中位时间为6(1,15)岁,中位体质量28(17,53.5)kg。结果:39例rPDAs均封堵成功,最常见的rPDAs的形态是漏斗型,中位直径2.4(2,4.3)mm;封堵器材的使用:3例使用可控弹簧圈,6例使用ADO-Ⅱ封堵器,28例使用普通蘑菇伞封堵器,2例使用室间隔缺损封堵器;本组患者中33例(85%)使用经典的顺行经肺动脉入路封堵,其中11例通过网篮抓捕建立轨道。6例患者因rPDAs细小穿刺股动脉,通过逆行入路封堵。结论:经导管封堵动脉导管未闭外科结扎及介入治疗术后的残余分流是一种创伤小、成功率高、并发症少、住院时间短及安全有效的方法。Objective: Residual patent ductus arteriosus(rPDAs) is one of the common complications after surgical or interventional therapy. This study explored the effect of reinterventional therapy for such complications. Methods: From January 2009 to December 2019, a total of 39 patients with rPDAs(including 38 after surgical ligation and 1 after interventional therapy) underwent transcatheter closure, including 12 males and 27 females. The median age was 17(5,33)years. After the initial surgery was closed, reinterventional therapy median time was 6(1,15)years. The median body weight was 28(17,53.5)kg. Results: 39 rPDAs were successfully closed.Most common ductal anatomy was the conicalshape. The median rPDA size was 2.4(2,4.3) mm. The devices:3 cases use coils,6 cases use ADO-Ⅱ Occluders, 28 cases used Amplatzer occluders, 2 cases used ventricular septal defect occluders;33 patients(85%) in this group of patients used the classic anterograde transpulmonary artery approach, 11 of which were passed through the net The basket catches the track. 6 patients were blocked by retrograde approach due to small puncture of femoral artery with rPDAs. Conclusions: Transcatheter occlusion of arterial catheters with surgical ligation and residual shunt after interventional therapy is a safe and effective method with little trauma, high success rate, few complications, short hospital stay.

关 键 词：动脉导管未闭 介入治疗 心脏外科手术 

分 类 号：R54[医药卫生—心血管疾病]