彩色多普勒超声在PDA栓塞术中的应用价值

Evaluation of application of CDU in Operative Embolization of PDA

目的：应用彩色多普勒超声（ＣＤＵ）预选动脉导管未闭（ＰＤＡ）栓塞适应证，减少塞子脱落和动脉损伤并发症，提高ＰＤＡ堵塞成功率。材料和方法：按Ｐｏｒｓｔｍａｎｎ法ＰＤＡ栓塞适应证标准，先经ＣＤＵ检测ＰＤＡ及股动脉内径，选出符合栓塞适应证的单纯ＰＤＡ３２例进行数字化ＰＤＡ和股动脉造影回顾性验证超声预选准确性。术者在ＣＤＵ导向下完成顶塞堵闭ＰＤＡ全过程，以取得最佳嵌顿位置并完全阻断分流。结果：术前ＣＤＵ预选准确性９６．８％，术中ＣＤＵ引导成功率１００％，３１例ＰＤＡ行栓塞术均一次成功，成功率１００％，其中２１例术后远期ＣＤＵ随访均未见塞子脱落和再通。结论：术前ＣＤＵ选择栓塞适应证准确可靠，术中ＣＤＵ定位法优于Ｘ线定位法。

Purpose: Color doppler ultrasound (CDU) was used to select the indication, to diminish the possibility of the plug exfoliation and the arterial injnry and to increase the chance of successful embolization in patients with patent ductus arteriosus (PDA). Materials and Methods:According to standard Porstmann's criterion and 32 cases of simple PDA conforming to embolization indication were selected to undergo digital PDA and femoral arterial angiography for verifing the accuracy of Ultrasonic preconcentration. The complete pocess of prlaging and blocking of PDA was directed by CDU in order to achieve the very best location of wedged plugs and to block the shunts completely. Results: The accuracy of predictive selection of PDA in preoperation examination is 96.8%, the rate of successful guidance by CDU in operation was 100%, 31 cases of embolization of PDA were succeeded in the first time of operation, the rate of success is 100%, 21 cases among them had no sign of postoperation plug exfoliation or recanalization in follow up survey. Canclusion: The selection of the embolization indications by CDU was accurate and reliable. The location of PDA by CDU was superior to x ray methods.