摘要
目的探讨介入治疗动脉导管未闭（PDA）的临床应用体会。方法1998年3月至2007年8月在我科介入治疗PDA 941例，其中男259例，女682例；年龄3个月-74岁（平均13.7岁）；体重3.5-101 kg（平均31.2 kg）。结果主动脉造影按Krichenko分类，A型641例（68.1%），B型11例（1.1%），C型202例（21.5%），D型8例（0.9%），E型79例（8.4%）。PDA最窄内径1.2-15（4.6±2.9）mm，主动脉端内径2.0-32.7（11.1±5.7）mm，长度2-42.6（6.7±3.3）mm；平均肺动脉压9.7-106（34.7±19.4）mm Hg。采用进口AGA蘑菇伞146例，AGA房间隔缺损封堵伞2例，国产PDA蘑菇伞720例，国产膜部室间隔缺损封堵伞18例，国产肌部室间隔封堵伞6例，国产偏心PDA封堵伞18例和德国pfm弹簧圈31例。7例未能完全封堵，治愈率达99.3%。结论绝大多数患者可用介入方法达到治愈，正确掌握PDA介入治疗的适应证范围，准确娴熟的操作技术能减少并发症的发生，慎重处理婴幼儿合并重度肺动脉高压的PDA患者，正确评价肺动脉高压的性质是介入治疗指征的关键。伴有重度肺动脉高压的PDA患者远期疗效尚需积累经验。
Objective To evaluate the clinical value of interventional therapy of patent cluctus arteriosus （PDA）. Methods A total of 941 patients （259 male and 682 female） with PDA admitted from March 1998 to August 2007,aged from 3 months to 74 years old （mean age 13.7 ± 14.5 years old） were included in this study. The clinical characteristics and the outcomes of the therapy were retrospestively studied. Results These PDA types were classified according to Krichenko＇s classification by aortic angiography. Among all the patients, 641 of then （68.1%） had type A PDA, 11 patients （1.1%） had type B, 202 patients （21.5%） had type C, 8 patients （0.85%） had type D ancl 79 patients （8.4%） had type E PDA. The ranges for the minimun inner diameter of PDA was 1.2 - 1.5 （4. 6 ±2. 9） mm, the inner diameter of aorta end was 2.0 -32. 7 （ 11.1 ±5.7） mm,the length was 2 -42. 6 （6. 7 ±3.3） mm and the mean pulmonary arterial pressure was 9.7 - 106 （ 34. 7 ± 19. 4 ） mm Hg, Various occlusion devices were used to close the PDA including AGA mushroom occluder in 146 patients, AGA atrioseptal defect device in 2 patients, homemade PDA cluctal occluders in 720 patients, homemade membranous ventricular septal defect device in 18 patients, homemade muscular ventficular septal defect device in 6 patients, eccentricity PDA devices in 18 patients and Germany pfm spring coil in 31 patients. Transcather closure was unsuccessful in 7 patietns and the success rate of operation was 99.3% （934/941）. Conclusion Most patients can be cured by catheterization closure. To master procedural indication and accurate manipulation skill can reduce the procedural complications. The procedures should be handled carefully in infants or patients with pulmonary artery hypertension. The evaluation of pulmonary artery pressure is the key point prior to the interventional therapy. The experience on long-term efficacy of transcatheter PDA closure in patients complicated with pulmonary artery hypertension needs further ex
出处
《中国介入心脏病学杂志》
2007年第6期306-309,共4页
Chinese Journal of Interventional Cardiology
关键词
动脉导管未闭
心脏导管插入术
治疗结果
Ductus arteriosus, patent
Heart catheterization
Treatment outcome
