经左侧桡动脉-右侧股静脉途径封堵成人动脉导管未闭的临床疗效观察

摘要

Objective To investigate the clinical safety and efficacy of transcatheter closure of patent ductus arteriosus (PDA) via the left radial artery-right femoral vein. Methods Forty adult PDA patients who were screened by color Doppler echocardiography were divide into two groups according to random number table method, PDA group (group A) by left radial artery - right femoral vein occlusion and PDA group (group B) by femoral artery -femoral vein occlusion. The success rate of closure, average operative time, average fluoroscopy time, average bed rest time and surgical complications were compared between the two groups. Results The success rate of closure, average diameter of blocked umbrella, average operation time (53.17±10.93 vs. 54.28±9.85, P=0.476), average fluoroscopy time (16.00±5.64 vs. 15.39±5.20, P=0.139) Significant statistical difference; The average bed rest time in group A was significantly shorter than that in group B (2.83±0.74 vs. 22.15±4.82, P<0.001), the difference was statistically significant (P<0.001). The incidence of surgical complications in group A was lower than that in group B (10.52%) vs. 33.33%, P=0.133), the difference was not statistically significant. Conclusion Both approaches are safe and effective, but the average time of bed rest and the incidence of operative complications of PDA occlusion via the left radial artery-femoral vein approach are low, which is worthy of clinical application.%目的 探讨经左侧桡动脉-右侧股静脉途径用封堵器封堵成人动脉导管未闭(PDA)的临床安全性与有效性.方法 连续入选2013年1月至2017年1月于新乡市中心医院心血管内科住院的成人PDA患者40例,按随机数字表法分为经左侧桡动脉-右侧股静脉途径封堵PDA(A组),经股动脉-股静脉途封堵PDA(B组)各20例,比较两组封堵成功率、平均手术时间、平均透视时间、平均卧床时间及手术并发症情况.结果 两组患者封堵成功率、平均封堵伞直径、平均手术时间(53.17±10.93 vs. 54.28±9.85, P=0.476)、平均透视时间(16.00±5.64 vs. 15.39±5.20,P=0.139)无明显统计学差异;A组平均卧床时间明显短于B组(2.83±0.74 vs. 22.15±4.82,P＜0.001),差异有统计学意义(P＜0.001);A组手术并发症发生率低于B组(10.52% vs. 33.33%,P=0.133),差异无统计学意义.结论 两种途径均是安全有效的,但经左侧桡动脉-股静脉途径封堵成人PDA的平均卧床时间短及手术并发症发生率低,值得临床推广.