动脉导管未闭三种堵闭方法的比较

Transcatheterclosureofpatentductusarteriouswiththreemethods

为比较动脉导管未闭三种堵闭方法的疗效，１９８９年３月～１９９４年１２月分别采用Ｐｏｒｓｔｍａｎｎ法、Ｒａｓｈｋｉｎｄ法及Ｓｉｄｅｒｉｓ法堵闭动脉导管未闭（ＰＤＡ）共５６例。其中Ｐｏｒｓｔｍａｎｎ法２３例，成功率９２％（２３／２５例）；Ｋａｓｈｋｉｎｄ法２３例，成功率１００％（２３／２３例），Ｓｉｄｅｒｉｓ法８例，全部成功。结果是：三种方法比较以Ｐｏｒｓｔｍａｎｎ法疗效最好，对２３例成功堵闭ＰＤＡ的患儿经３年随访，无一例有残余分流，但其适应证范围小，且并发症较多；Ｒａｓｈｋｉｎｄ法和Ｓｉｄｅｒｉｓ法适应证范围广，操作简便，但术后２４小时残余分流发生率较高，分别为２６％（６／２３例）和２５％（２／８例）。提示，后两种方法值得改进后推广应用。

BetweenMarch1989andDecember1994,transcatheterclosureofpatentductusarteriouswasperformedin56caseswiththeuseofPorstmann′smethod,Rashkind′smethodandSideris′method.Ratesofsucesswere92%(23/25)forPorstmann′smethod,100%(23/23)forRashkind′smethodand100%(8/8)forSideris′method,respectively.Folow-upstudiesincludedtwo-dimensionalDopplerechocardiographywithcolorflowmapping.The3-year-folow-upstudyre-vealednoresidualshuntin23patientswithPorstamnn′smethod.Andthe24-hour-folow-updemon-stratedasmalresidualshuntin26%(6/23)and25%(2/8)ofpatientsinwhomRashkind′smethodandSideris′methodwereusedrespectively.