经胸超声心动图指引下儿童漏斗型动脉导管未闭封堵术临床应用

Clinical Application of Transcatheter Closure in Patent Ductus Arteriosus under the Guidance of Transthoracic Echocardiography

目的探讨经胸超声心动图指引下儿童漏斗型动脉导管未闭封堵术能否作为传统漏斗型动脉导管未闭微创治疗的改良方法。方法选择昆明医科大学第一附属医院心血管二病区2015年10月至2017年7月,已排除合并其他心血管畸形的115例1～14岁单纯漏斗型动脉导管未闭患者,平均年龄3.58岁,随机分为观察组66例,经胸超声心动图指引下行动脉导管未闭封堵术;对照组49例,应用传统常规动脉导管未闭封堵术,即通过降主动脉造影和X线引导下进行封堵。结果漏斗型动脉导管最窄处直径2～8 mm的患者中,观察组较对照组麻醉手术时间短、总射线量及造影剂使用量小、总住院费用低、手术并发症少(P <0.05)。结论经胸超声心动图指引下儿童漏斗型动脉导管未闭封堵术具有操作简捷、麻醉手术时间短,不需造影剂,并发症少,患者住院费用低等优点,值得临床推广应用。

Objective To investigate whether the transcatheter closure of funnel shaped patent ductus arteriosus(PDA) under the guidance of transthoracic ultrasound can be used as a modified treatment method for traditional PDA closure, so as to shorten the time for operation, patients and operators under the X-ray, and to generalize the method. Methods There were 115 FDA cases of 1-14 year-old with an average in 3.5, who were chosen from September 2015 to September 2017 of the First Affiliated Hospital of Kunming Medical University,which were excluded from cardiovascular malformations and divided into observation group by 66 cases in random,and the rest 49 cases were selected as control group. Traditional descending aortographies and the X-ray guiding were applied to the control group. Results The accuracy of the experimental group was higher than that of the control group when the narrowest arterial duct rages from 2 mm to 8 mm, the differences was statically significant(P<0.05). Also, the incidence of operative complications was statistically significant(P<0.05). Conclusion TTE guided PDA closure has the advantages of simple operating, time saving, without contrast media using,safety and reliability, wide operation and low cost, it has great potential for development and broad application.