低体重儿童动脉导管未闭封堵治疗的疗效观察

Therapeutic Effect of Patent Doctus Arteriosus Closer for Low Body Weight Children

目的：探讨低体重儿童动脉导管未闭封堵治疗的疗效和安全性．方法2008年1月至2012年6月昆明医科大学附属延安医院对体重＜8 kg的婴幼儿PDA 32例（男14例，女18例）实施经导管介入封堵治疗，年龄6-18月，平均（11±5.5）月，体重（7.2±0.6） kg，主动脉造影示PDA最窄径为1-8 mm （4.6±1.7） mm，封堵后即刻和30 min行侧位降主动脉造影，术后1 d，1、3、6个月分别行超声心动图及X线摄片检查．结果30例封堵治疗成功，成功的患者均采用国产PDA封堵器，1例术中造影合并降主动脉缩窄和室间隔缺损，转外科治疗；1例为PDA封堵器主动脉侧过大，导致降主动脉狭窄，放弃封堵；2例术后即刻存在微量-少量残余分流；随访均未发生严重并发症．结论应用国产封堵器经导管治疗体重〈8 kg的婴幼儿的PDA是一种安全有效、简便、创伤小、恢复快的介入治疗方法．

Objective To discusses the efficacy and safety of patent ductus arteriosus sealing for low body weight children. Methods From January 2008 to June 2012 in our hospital,32 cases （male14 and female 18） of PDA babies＆lt; 8 kg weight were given transcatheter closure treatment. The enrolled PDA babies aged 6 month-18 months, average （11 ±5.5 months）,weighted （7.2 ±0.6） kg,aortic imaging showed the narrowest diameter of PDA was 1 - 8 mm （4.6 ±1.7） mm,descending aorta imaging was performed immediately and 30 min after transcatheter closure treatment. Echocardiography and X-ray radiography examination were performed 1 d,1,3, 6 months after treatment. Results 30 cases got successful patent ductus arteriosus sealing,all the successful patients were treated with domestic closer,and 1 case was complicated with the descending aorta stenosis and ventricular septal defect, and was transferred to surgerical treatment. 1 case of PDA gave up patent ductus arteriosus sealing as descending aorta stenosis caused by the closer. 2 cases were found a trace-residual shunt immediately after patent ductus arteriosus sealing. No serious complications were found in all patients during the follow-up period. Conclusions Application of domestic closer in treatment of PDA infants 〈 8 kg is a safe, effective and simple intervention treatment method with little trauma and fast recovery.