摘要
目的:总结经导管封堵治疗动脉导管未闭中封堵器选择的经验,并观察置入物的血液相容性。方法:对象为2005-06/2007-04在苏州大学附属第一人民医院收治66例拟行动脉导管未闭堵闭的患儿,术前行主动脉弓降部侧位造影了解动脉导管未闭的形态、位置,测量最窄处直径。按比所测动脉导管未闭最窄处直径大3～5mm的原则选取Amplatzer或国产先健牌封堵器;动脉导管未闭最窄处直径小于2mm的选用弹簧圈堵闭。结果:①动脉导管未闭类型:66例患儿中呈漏斗状59例,管型5例,漏斗型+管型1例,动脉导管未闭结扎手术后残余分流1例。②封堵器选择:选择蘑菇伞型封堵器堵闭的61例患儿,动脉导管未闭最小直径2～16mm,平均(3.75±2.29)mm;选用的封堵器肺动脉端直径为4～24mm,平均(8.07±3.37)mm;动脉导管未闭最小直径小于2mm的5例患儿,选用弹簧圈。③堵闭结果:66例中64例经导管封堵成功(成功率96.9%),2例术后封堵器移位,转外科手术结扎。④材料血液相容性和宿主反应:未发现溶血、股动脉血栓形成,术后随访12个月未见残余分流、再通及封堵器移位。结论:应用Amplatzer、国产先健牌封堵器和弹簧圈均能安全地封堵多种类型动脉导管未闭,根据造影测量动脉导管未闭处形态、位置及最窄处直径选择封堵物成功率高。
AIM： To summarize experience of occluder selection for transcatheter closure of patent ductus arteriosus （PDA） and observe the blood compatibility of the implants. METHODS： Sixty-six child patients undergoing PDA in First People＇s Hospital of Soochow University between June 2005 and April 2007 were selected. The type and location of PDA were observed by lateral aortic arch angiography at the descending part, and PDA minimal diameter was measured. The diameter of the ductal occluder selected, Amplatzer or domestic ductal occluder （Xianjian）, was 3-5 mm larger than the PDA minimal diameter. Coil occlusion was selected to close the PDA of minimal diameter less than 2 mm. RESULTS： （1）Of 66 patients, 59 had funnel-shaped PDA, 5 had tubular PDA, 1 had funnel plus tubular shape PDA, and 1 had residual shunt after operation. （2）PDA minimal diameter of 61 patients undergoing occlusion by mushroom type occluder was 2-16 mm with an average of （3.75±2.29） mm, and the diameter of occluder used was 4-24 mm, with an average of （8.07±3.37） mm. Five patients whose PDA minimal diameter was less than 2mm were treated by Coil occlusion. （3）Of 66 patients, 64 patients were successful occluded （achievement ratio 96.9%）. After operation, occluder dislocation was found in 2 patients, and treated by surgery. （4）No complications occurred such as hemolysis, or femoral artery thrombosis. No residual shunt, PDA recanalization or occluder dislocation was found at the time of the final 12-month follow-up. CONCLUSION： PDA can be effectively and safely closed using the Amplatzer, Xianjian ductal occluder or Coil occlusion. Occlusion success rate is high by selecting occluder based on angiography to identify the type and location of PDA and minimal diameter.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第13期2445-2447,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
