国产封堵器与外科手术治疗动脉导管未闭的比较

Comparative study of Chinese-made occluders and surgical procedures in closure of patent ductus arteriosus

目的：比较国产封堵器与外科手术治疗动脉导管未闭（PDA）的疗效、并发症和手术时间。方法：2002年1月～2006年12月我院应用国产封堵器介入治疗PDA患者79例，同期开胸手术治疗33例，比较两种疗法的主要并发症及远期疗效等。结果：介入治疗组技术成功率99％，并发血红蛋白尿1例，全组远期随访均保持优良生存，未成功的1例择期行开胸手术治疗。开胸手术组全部成功，并发症有：肺不张1例，胸腔积液2例，进行性血胸二次开胸止血1例，手术伤口感染1例，远期随访术后再通1例，肋骨骨髓炎1例，胸痛1例，均再次接受治疗。结论：国产封堵器介入治疗PDA安全可靠，创伤小、并发症少，远期疗效优良，在其适应证范围内可替代开胸手术。

AIM： To compare the clinical effectiveness of Chinese-made occluders and surgical procedures in closure of patent ductus arteriosus （PDA）. METHODS： Major complications and long-term clinical results of PDA closure were compared among 79 patients treated with Chinese-made occluders and 33 patients treated surgically. RESULTS： In the group treated with Chinese-made occluders, the technical success rate was 99%. Hemoglobinuria occurred in one case （ 1% ）. The one unsuccessful case underwent surgical closure. All patients in the surgical group were successfully treated. Pulmonary atelectasis occurred in one case, hydrothorax in two cases, progressive hemothorax in one case and incision infection in one case. The major complication rate was 15%. Long-term follow-up demonstrated postoperative recanalization in one case, rib osteomylitis in one case, and chest pain in one case. CONCLUSION： Chinese-made occludes are safe and reliable in transcatheter closure of PDA, with fewer complications and better longterm results than surgical procedures.