摘要
目的 Amplatzer封堵器试验性关闭动脉导管未闭(PDA) ,评价其在 PDA合并重度肺动脉高压 (SPH)患者封堵治疗中的临床价值 .方法 对 7(男 4,女 3)例 PDA合并 SPH患者实施 PDA封堵器堵塞 PDA试验 ,观察肺动脉收缩压、肺动脉平均压有无降低及血氧饱和度变化 ,以此分析肺血管病变是否可逆 .结果 7例重度肺动脉高压者 ,肺动脉收缩压11.3～ 18.7(12 .8± 4.9) k Pa,平均压为 6 .9～ 12 .3(9.1±2 .5 ) k Pa,其中 2例血氧饱和度小于 90 % ,6例试封堵术后30 min～ 1h肺动脉收缩压降至 6 .0～ 13.1(7.6± 3.1) k Pa,肺动脉平均压降至 2 .7～ 8.3(4 .4± 2 .8) k Pa,行永久性封堵治疗 . 1例肺动脉压和动脉血氧饱和度无明显变化 ,为阻力性肺动脉高压 ,不宜进行封堵治疗 .结论 对于 PDA伴严重肺动脉高压者 ,Amplatzer封堵器关闭 PDA试验是鉴别肺动脉高压是否为阻力性肺动脉高压的安全有效的方法 ,在 Am -platzer法封堵器治疗 PDA合并重度肺动脉高压 (SPH)的病例选择中有重要的临床价值 .
AIM To evaluate the clinical usefulness of experimental transcatheter closure of patent ductus arteriosus (PDA) using the Amplatzer duct occluder (ADO) in the closure of PDA with severe pulmonary hypertension (SPH). METHODS Experimental transcatheter closure of PDA using ADO was performed in seven patients suffering from PDA with SPH. The changes of pulmonary hypertension and SaO 2 was monitored 30 min to 1 h to distinguish between reversible and irreversible elevations in pulmonary vascular resistance. RESULTS The systolic pulmonary hypertension was decreased from 11.3~18.7 (12.8±4.9) kPa(1 mmHg=0.133 kPa) to 6.0~13.1 (7.6±3.1) kPa, the mean pulmonary hypertension was decreased from 6.9~12.3 (9.1±2.5) kPa to 2.7~8.3 (4.4±2.8) kPa in 6 cases 30 min to 1 h after the experimental closure, implying for permanent transcatheter closure of PDA by ADO. Pulmonary pressure and SaO 2 failed to respond in one case after the procedure, implying resistant pulmonary hypertension. The permanent transcatheter closure was not recommended and the ADO device was removed. CONCLUSION Experimental transcatheter closure of PDA using ADO provides a safe and effective way to determine the presence and extent of obstructive pulmonary vascular changes and plays an important role in the patient choice of PDA with SPH during transcatheter closure of PDA with SPH using ADO device.
出处
《第四军医大学学报》
北大核心
2001年第21期1924-1926,共3页
Journal of the Fourth Military Medical University
