摘要
目的探讨体质量≤8妇小儿动脉导管末闭（PDA）介入治疗方法的临床经验及安全性和有效性。方法收集2001年5月--2013年8月确诊为PDA的102例体质量均≤8kg患儿，通过经皮封堵术介入治疗，6min后行主动脉弓降部造影，术后24h、1、3、6个月行X线胸片、心电图、超声心动图检查，观察治疗效果。结果102例患儿中漏斗型58例，管型39例，窗型1例，不规则型4例，PDA肺动脉端最窄处直径为2～10[nin，平均（4．8±1．6）mm，选择Amplatzer公司生产的蘑菇伞型封堵器25例，新型ADO—II封堵器5例，Plug1例．国产蘑菇伞型PDA封堵器69例，室间隔缺损封堵器2例，所选择蘑菇伞型封堵器腰部直径为6—16mm。术前肺动脉平均压≥25mmHg者87例，其中43例≥50mmHg，封堵后10min测量肺动脉平均压均有不同程度下降，符合动力型肺动脉高压。102例患儿均治疗成功，成功率100％。结论低体质量PDA患儿由于自身特点有其特殊性，介入治疗存有一定风险，如果术前准备充份，术中操作谨慎、细致，封堵器选择适当，注意预防并发症发生，仍为一种安全有效的方法。
[Abstract] Objective To explore the safety and effectiveness of interventional transcatheter closure of patent ductus arteriosus （PDA） in infants with body weight under 8 kg, and to summarize the clinical experience. Methods During the period from May 200l to August 2013, a total of 102 PDA children with body weight ~〈 8 kg were admitted to the hospital. All patients were underwent transeatheter closure and angiography of the arch and descending aorta was carried out at 6 minutes after the closure procedure. Chest film, ECG and echocardiography were performed at 24 hours, 1 month, 3 months and 6 months after the operation in order to evaluate the clinical therapeutic efficacy. The results were analyzed. Results Of the 102 PDA patients, funnel type was seen in 58, tubular type in 39, window type in 1 and irregular type in 4. The narrowest diameter at pulmonary artery side of PDA was 2 - 10 （4.8 _＋ 1.6） ram. The occluder used in the patients included mushroom occluder produced by Amplatzer company （n = 25）, new type Amplatzer ADO- lI occluder （n = 5）, Ampiatzer Plug （n = 1）, domestic-made PDA mushroom occluder （n = 69） and domestic-made VSD occluder （n = 2）. The waist diameter of the mushroom oceluders used in the patients was 6 - 16 ram. The preoperative mean pulmonary pressure t〉 25 mmHg was seen in 87 paticnts, and /〉 50 mmHg in 43 patients. Ten minutes after occlusion, the mean pulmonary pressure decreased to different extent, which was consistent with dynamic pulmonary artery hypertension. Successful treatment was obtained in all patients with a success rate of 100%. Conclusion For PDA infants with low body weight interventional treatment carries certain risks. However, transcatheter closure is still a safe and effective method for PDA infants when close attention to the sufficient preoperative preparation, careful manipulation, the selection of proper oecluder and the prevention of complications are paid. （J Intervent Radiol, 2014,
出处
《介入放射学杂志》
CSCD
北大核心
2014年第2期100-103,共4页
Journal of Interventional Radiology
