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封堵器介入治疗动脉导管未闭的临床研究

Clinical Observation for Interventional Treatment of Patent Ductus Arteriosus Using Home- made Mushroom Type Occluder
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摘要 目的国产蘑菇伞型封堵器介入治疗动脉导管未闭(PDA)的临床观察及其疗效分析。方法32例PDA患者于主动脉弓降部造影,测量动脉导管大小,在透视下经传送装置将国产蘑菇伞型封堵器置入动脉导管内,使之在动脉导管最窄处固定,即刻造影,术后行超声心动图(UCG)检查。结果全组技术成功率100%;主动脉弓造影即刻无分流26例;5例存在微量或少量残余分流,经UCG复查,其中4例术后48h分流消失,1例术后3月分流消失;封堵后即刻肺动脉平均压由封堵前(40±15.3)mmHg下降至(33±14.1)mmHg(P〈0.05);术后3月左、右心室舒张末期容积均较术前缩小(92±29.4)ml VS(110±30.2)ml,(54±11.3)ml VS(63±15.0)ml,P〈0.05)。结论应用国产蘑菇伞型封堵器治疗动脉导管未闭操作方法简便,治疗范围广,成功率高,不失为很有前途的代替进口封堵器的介入性治疗方法。 Objective Clinical observation and effecacy analysis for interventional treatment of patent ductus arteriosus (PDA)by using home- made mushroom type oceluder. Methods Descending aortographies were performed for 32 cases of PDA qatients to measure the size of ductus arteriosus. Home - made mushroom type occluder was placed in ductus arteriosus and fixed at the narrowest position via transfer device with guidance of fluoroscopy. Angiography was performed immediately and Echocardio- graphy(UCG)examinafion was performed after the procedure. Rosults technical success rate of the whole group was 100% . Aortography showed that 26 cases trod no shunt immediately and 5 eases had trace or few residual shunts, which disappeared 48h after the procedure in 4 eases and 3 m after the procedure in 1 case as re - examined with UCG. Mean pulmonary artery pressure was reduced from (40 ± 15.3)mmHg before closure to (33 ± 14,1 )mmHg( P 〈 0.05)after closure. Left and right ventricular end diastolic voltune ( LVEDV and RVEDV) was respectively reduced by (92 ± 29.4 ) ml VS ( 110± 30.2) ml and ( 54± 11.3 ) ml VS (63 ± 15.0)ml, P 〈 0.05,3 m after the procedure. Conclusion Application of home - made mushroom type oeeluder in treat- ment of PDF has simple operation method, extensive range of treatment and high success rate. It is no doublt an up - and - coming interventional therapy that might replace imported oeeluder.
出处 《常州实用医学》 2008年第6期351-353,共3页 CHANGZHOU PRACTICAL MEDICINE
关键词 动脉导管未闭 经导管封堵术 临床研究 疗效 patent ductus arteriosus transeatheter closure
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