超声心动图对动脉导管未闭封堵术48例疗效评价

Value of Echocardiography in Evaluating Curative Effect of Transcatheter Closure of Patent Ductus Arteriosus

目的:探讨超声心动图在动脉导管未闭(PDA)封堵术疗效评价中的价值。方法:48例PDA患者经导管进行封堵术。在术前及术后1周分别进行超声心动图的检查,观察大动脉水平有无分流及心脏大小、功能的改变。结果:术后1周复查,肺动脉平均内径从32.1mm缩小到25.3 mm,P<0.05;左室舒张末期平均内径从55.4 mm缩小到48.9mm,P<0.001;左房平均内径从30.7mm缩小到28.1mm,P<0.01;左室射血分数虽然从64.4％下降到62.4%,但未见统计学差异,P>0.05。术后1周复查3例患者均存在少量残余分流,3个月后随访残余分流消失。结论:经导管介入治疗PDA是一种创伤小、疗效高的非开胸治疗先天性心脏病的方法,超声心动图对术前患者的筛选,术后检测有无残余分流,对心脏血流动力学评价及疗效的观察起了重要的作用。

Objective: To probe the value of echocardiography in evaluating the curative effect of transcatheter closure of patent ductus arteriosus in 48 patients. Methods: The diameter of pulmonary artery, the diameter of the left atrium, the diameter of the left ventricle and EF of the left ventricle on echocardiogram were obtained in the first week before and after operation. Results: Before operation the mean diameter of pulmonary artery, the left atrium and the left ventricle were 32. 1 mm, 30. 7 mm, 55. 4 mm respectively and the EF of the left ventricle was 64. 4%. After operation the mean diameter of pulmonary artery, the left ftrium and the left ventricle were decreased to 25. 3 mm, 28. 1 mm and 48. 9 mm respectively. There were significant differences in all patients, P < 0. 05. The EF of the left ventricle was decreased to 62. 4%, P > 0. 05. A small shunt was detected in 3 patients in the first week after operation, but it disappeared 3 months later. Conclusion: Transcatheter closure of patent ductus arteriosus is a safe and effective method for treatment of congenital heart desease . Echocardiography can be used to select proper patients and detect whether there is residual shunt later. It is also available to evaluate hemodynamical change and curative effect.