未闭动脉导管经皮弹簧栓栓堵方法的临床研究

Clinical Study of Percutaneous Transcatheter Closure of Patent Ductus Arteriosus Using Detachable Coil

目的：研究建立一种经皮可释放性弹簧栓栓堵治疗动脉导管未闭（ＰＤＡ）的新方法。方法：经主动脉造影测定ＰＤＡ内径及长度，在Ｘ线和超声心动图监测引导下，经心导管将可释放性弹簧栓栓堵于ＰＤＡ。分别采用Ｊａｃｋｓｏｎ弹簧栓（Ｊ组）和ＰＤＡ弹簧栓（Ｐ组）。经临床、主动脉造影和超声心动图确定疗效。结果：采用本法治疗２１例，ＰＤＡ平均最狭窄处内径３．１８±０．６２ｍｍ（范围１．５～４．７ｍｍ，其中８１％超过３ｍｍ），平均长度５．１７±２．１３ｍｍ。２０例获得成功且无并发症，术后经临床、主动脉造影和超声心动图检查，无残余分流。其中Ｊ组８例均获成功；Ｐ组１３例，成功１２例、失败１例。结论：本法属于安全可靠的非开胸治疗ＰＤＡ的新方法，创伤性很小，值得使用。

Objective:To develop a new clinical method of percutaneous transcatheter closure of patent ductus arteriosus(PDA) using detachable coil. Methods:After the internal diameter and length of PDA were estimated by aortography,a set of detachable coil(Jackson coil for J Group and PDA coil for P Group) was delivered,released and lodged in the PDA through a catheter engaged retrogradely,under the monitoring of echocardiography and X ray. The results were comfirmed by clinical,aortographic and echocardiographic studies. Results:Twenty one patients were eligible.The narrowest internal diameter and length of PDA were 3 18±0 62 mm(range 1 5—4 7 mm,81%>3 mm) and 5 17±2 13 mm,respectively.Among them,20 cases were successfully treated using detached coils without any complications.There were no clinical,angiographic and echocardiographic evidences of residual shunting,including 8/8(100%)in J Group and 12/13(92%)in P Group. One case in P Group was failed. Conclusions:The study shows that the transcatheter coil closure of PDA is a new ,safe and less invasive method for the treatment of patients with PDA,so it is worthy to be used.