【摘要】 目的探讨单静脉入路国产封堵器(Amplatzer法)治疗动脉导管未闭(PDA)的有效性和安全性。方法12例动脉导管未闭,病变最窄处直径为3～12(5.35±3.26)mm,经股静脉建立右房→右室→肺动脉→动脉导管→主动脉轨道,主动脉弓降部侧位造影观察PDA的位置、形态、大小,经股静脉建立的轨道进行封堵。术后即刻经胸超声及心脏听诊判断有无分流。术前、术后均行血流动力学测定,术后24h、1个月、3个月、6个月复查超声心动图,观察大动脉水平有无分流及有无PDA再通。结果12例患者全部一次封堵成功,技术成功率100%。心导管检查测肺动脉收缩压由术前轻度增高[(34.10±2.67)mmHg]降为正常[(20.30±3.10)mmHg]。所有患者术后即刻心前区双期连续性杂音消失,术后即刻彩超检查无分流,操作透视时间7.50～12.30(8.96±2.30)min。无任何并发症发生,随访1个月、3个月、6个月未发生动脉水平分流及动脉导管再通。结论单静脉入路国产封堵器治疗动脉导管未闭简化了手术程序,减少了血管并发症,缩短了操作透视时间,手术成功率高,疗效可靠,价格低廉,值得临床借鉴。更多还原

【Abstract】 Objective To evaluate the efficiency and safety in the application of native made occluder for single-verous transcatheter closure of children patent ductus atrenious (PDA). Methods 12 Patients aged 1-12(3.8±4.6) years with body weight 9.5-35.0(12.6±8.7)kg were established RA→RV→PA→PDA path through femoral vein. The PDA diameter at narrowest segment was 3～12(5.35±3.26)mm, according to the lateral descending aortographies. The suitable native made occluder was selected. Echocardiographies and heart auscultation were performed to evaluate the immediate results the procedure. Echocardiographies were performed 24 hours, 1 month, 3 month, 6 month after the procedure to find whether there was residual shunt and recanalization. Results 12 patients had successful device placement at the first time. The success rate was 100%. The pulmonic systole pressure revived to normal (20.30±3.10)mm Hg after the procedure .Continuous murmur disappeared in all patients. The fluoroscopy time was 7.50-12.30(8.96±2.30)min. There were no complications. No residual shunt and PDA recanalization after the complete closure were found during 1, 3 and 6 months follow-up. Conclusion The single-verous transcatheter closuer of PDA using native made occluder device simplify operation procedure, shorten the fluoroscopy time. Similar results was got by single-verous transcatheter closure with traditional operational precedure.更多还原