超声心动图与心导管造影测量动脉导管最小内径的吻合率及临床意义

摘要

目的 探讨经胸超声心动图(TTE)与心导管造影测量动脉导管(PDA)内径的吻合率及临床意义.方法 2008年6月～2009年9月,我单位对63例PDA进行介入封堵治疗.男25例,女38例,年龄5个月～13岁(中位年龄4.5岁),体质量(17.2±5.1)kg.比较经胸超声心动图与心导管造影测量动脉导管最小内径的吻合情况.结果 超声心动图和心导管造影测量动脉导管最窄处内径无明显差异.59例患儿应用国产PDA封堵器封堵成功,3例放置Cook公司弹簧圈,1例由于PDA粗大、呈短管型合并重度肺动脉高压,放弃封堵.封堵术后3～5 d出院,近期随访无不良反应.结论 经胸超声心动图可达到与心导管造影测量动脉导管最窄处内径相当的吻合率,对于术前选择、封堵器械准备,评估病情具有较大的临床价值.%Objective To explore the coincidence of transthoracic echocardiography(TTE)and angiograhy in evaluation the dimension of patent ductus arteriosus(PDA)and its clinical significance.Methods 63 cases with PDA underwent transcatheter intervention between June 2008 and September 2009 with 25 boys and 38 girls[aged from 5 months to 13 years(median 4.5 years),bodyweight 17.2±5.1 kg].Coincidence of TTE and angiography in PDA were compared.Results There was no significant difference between TTE and angiograhy.59 cases were closed with domestically-made PDA occluders,3 with Cook spring coils and 1 failed for large duct associated with severe pulmonary hypertension and converted into thoracotomy.They were discharged 3 to 5 days after occlusion without adverse effects.Conclusions TTE can reach the same coincidence in measuring the narrowest internal diameter of ductus arteriosus as angiography.It is of great value in occluder selection,preparation and disease evaluation.