摘要：
目的 分析体重≤6 kg的婴幼儿接受不同的封堵器械进行经导管动脉导管未闭(PDA)封堵的结果.方法 对体重≤6 kg的PDA患儿进行回顾性分析.所有患儿均来自于华中科技大学同济医学院附属协和医院、武汉亚洲心脏病医院、湖北省妇幼保健院、武汉市第一医院四所医疗中心,在2008年1月至2015年12月期间接受经皮PDA介入封堵术.结果 适合做心脏导管介入的13例PDA患儿,年龄19天至1.3岁,平均(4.6±2.7)个月,体重2.5～6.0(4.6±0.9)kg;血管造影PDA的最窄处直径为1.0～7.3(2.9±1.1)mm.10例患儿成功置入了封堵装置(10/13),3例失败.平均透视时间11～52(22± 15)min.术中使用了多种类封堵装置和动、静脉鞘.术后即刻无房室瓣关闭不全、无新出现的心律失常、没有需要输血的病例、未出现穿刺部位血肿等、无卒中或死亡病例.术后即刻造影,2例患儿存在残余分流(2/13).最后一次随访时经彩色多普勒检查均未见残余分流.所有患儿左心室/右心室直径均在正常范围,无新出现的心律失常,未观察到降主动脉血流加速.结论 谨慎的选择病例,体重为2.5～6.0 kg的婴幼儿在经验丰富的介入中心可以安全并且成功地进行经皮PDA封堵术.%Objective To analyze the results of transcatheter closure of patent ductusarteriosus(PDA) using different devices in infants weighing less than 6 kg.Methods A retrospective analysis of infants weighing less than 6 kg was performed.All infants underwent transcatheter PDA closure between January 2008 and December 2015,from four medical centers at Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan Asia Heart Hospital,Hubei Maternal and Child Health Hospital,and Wuhan NO.1 Hospital.Results The 13 patients with PDA who were suitable for cardiac catheterization were 19 days to 1.3 years old,with an average of (4.6±2.7)months,weighing 2.5-6.0(4.6±0.9)kg.The mean minimum diameter of PDA for angiography was 1.0-7.3(2.9±1.1)mm.Ten patients were successfully implanted with a closure device(10/13),and 3 cases failed.The average fluoroscopy time was 11-52(22±15)min.A variety of occlusive devices and arterial and venous sheaths were used during the procedure.Immediately after intervention,there was no atrioventricular valve insufficiency,no new arrhythmia,no need for blood transfusion,no hematoma at the puncture site,no stroke or death.Immediate postoperative angiography show that there were residual shunts (2/13) in 2 patients.At the final follow-up,no residual shunts were seen by Color Doppler.Left ventricle/right ventricle diameter were in the normal range in all patients,no new arrhythmia occurred,and no accelerated descending aorta blood flow was observed.Conclusion In carefully selected cases,infants weighing 2.5-6.0 kg,percutaneous PDA closure can be performed safely and successfully in experienced intervention centers.
