经导管介入治疗婴幼儿动脉导管未闭临床疗效分析

摘要

目的:探讨经导管介入治疗婴幼儿动脉导管未闭(PDA)的治疗意义、临床经验、操作技术及安全性.方法:回顾性分析经导管介入治疗婴幼儿PDA 348例临床资料.男性226例,女性122例.年龄:4个月～3岁,平均1岁7个月,体质量:4.5 ～18 kg,平均10.2 kg.常规右心导管检查,主动脉弓降部造影,置入封堵器.术后24 h,1个月、3个月、6个月及12个月行超声心动图(UCG)检查.结果:PDA最窄处内径2.5～8.2 mm(平均3.97 mm),QP/QS 1.1 ～ 17.6(平均3 54).肺动脉高压252例(72 4％),术后肺动脉压力均有显著下降.封堵后29例(8.3％)存在微量至少量残余分流,均于封堵术后6个月内完全消失.345例经导管介入治疗成功,技术成功率99.14％.3例封堵器移位,转外科手术治疗.结论:经导管介入治疗婴幼儿动脉导管未闭,具有安全、有效、操作简便及适应证广等优点,可作为治疗大多数婴幼儿动脉导管未闭的首选方法.%Objective: To explore the significance, operation and security of transcatheter occlusion of patent ductus arteriosus(PDA) in infant. Methods: The retrospective analysis were performed in 348 PDA patients (226 male and 122 famale) who underwent the interventional therapy. They were aged 4months to 3 years, the mean age was 19 months, weighted 4. 5 to 18 kg, the mean weight was 10. 2 kg. Cardiac calheterization and aortographies was practiced, then closed PDA with suitable Occluder, echocardiogram was used to estimate the result on 24h, 1,3,6, 12 month. Results: The mean PDA diameter at its narrowest segment was 3.97 mm ( rang 2. 5 to 8. 2). The mean QP/QS was 3. 54mm (rang 1. 1 to 17.6). 252 patients(72. 4% ) with pulmonary hypertension, After the procedure the pulmonary arterial pressure decreased observably. 29 patients (8. 3% ) had a trace to small shunt after occlusion, no residual shunt 6 months later. The transcatheter closure was conducted successfully in 345 patients with successful rate was 99. 14%. 3 patients accepted surgical operation for migration of the devices. Conclusion: Transcatheter closure infants ductus is safe and effective, and the indication is extensive. It should be the first choice of infants PDA.