经导管介入治疗婴幼儿动脉导管未闭临床疗效分析

Clinical effect of patent ductus arteriosus in infants treated with transcatheter closure

目的:探讨经导管介入治疗婴幼儿动脉导管未闭(PDA)的治疗意义、临床经验、操作技术及安全性。方法:回顾性分析经导管介入治疗婴幼儿PDA 348例临床资料。男性226例,女性122例。年龄:4个月～3岁,平均1岁7个月,体质量:4.5～18 kg,平均10.2 kg。常规右心导管检查,主动脉弓降部造影,置入封堵器。术后24 h,1个月、3个月、6个月及12个月行超声心动图(UCG)检查。结果:PDA最窄处内径2.5～8.2 mm(平均3.97 mm),QP/QS 1.1～17.6(平均3.54)。肺动脉高压252例(72.4%),术后肺动脉压力均有显著下降。封堵后29例(8.3%)存在微量至少量残余分流,均于封堵术后6个月内完全消失。345例经导管介入治疗成功,技术成功率99.14%。3例封堵器移位,转外科手术治疗。结论:经导管介入治疗婴幼儿动脉导管未闭,具有安全、有效、操作简便及适应证广等优点,可作为治疗大多数婴幼儿动脉导管未闭的首选方法。

Objective：To explore the significance,operation and security of transcatheter occlusion of patent ductus arteriosus（PDA） in infant.Methods： The retrospective analysis were performed in 348 PDA patients（226 male and 122 famale） who underwent the interventional therapy.They were aged 4months to 3 years,the mean age was 19 months,weighted 4.5 to 18 kg,the mean weight was 10.2 kg.cardiac catheterization and aortographies was practiced,then closed PDA with suitable Occluder,echocardiogram was used to estimate the result on 24h,1,3,6,12 month.Results： The mean PDA diameter at its narrowest segment was 3.97 mm（rang 2.5 to 8.2）.The mean QP/QS was 3.54mm（rang 1.1 to 17.6）.252 patients（72.4%） with pulmonary hypertension,After the procedure the pulmonary arterial pressure decreased observably.29 patients（8.3%） had a trace to small shunt after occlusion,no residual shunt 6 months later.The transcatheter closure was conducted successfully in 345 patients with successful rate was 99.14%.3 patients accepted surgical operation for migration of the devices.Conclusion： Transcatheter closure infants ductus is safe and effective,and the indication is extensive.It should be the first choice of infants PDA.