摘要
目的 对比研究Amplatzer封堵器和外科手术治疗动脉导管未闭 (PDA)的疗效和费用 ,探讨Amplatzer封堵器治疗PDA的可行性。方法 1999年 4月～ 2 0 0 0年 7月 ,在我院行外科手术治疗的PDA患者 6 9例 ,同期行Amplatzer封堵器治疗的PDA患者 111例。比较两种方法的疗效、费用等情况。结果 Amplatzer组技术成功率 98 2 % ,无并发症。未成功的 2例PDA患者均择期行手术治疗。外科手术组全部成功 ,无死亡。并发症为肺不张 7例 ,气胸 4例 ,冠状动脉空气栓塞 1例 ,心脏骤停 1例 ,喉返神经损伤 2例 ,术后再通 1例。 12例患者术中输血 2 0 0～ 80 0ml,平均输血 (483 3± 2 16 7)ml。Amplatzer组平均总费用显著高于外科组 ,其中手术费用相似 ,器材费用前者 (封堵器 )显著高于后者(P <0 0 1)。结论 Amplatzer封堵器在其适应证范围内可替代外科手术。降低Amplatzer封堵器的费用 ,有助于其更广泛应用。
Objective To compare the cost and clinical effectiveness of transcatheter Amplatzer device with those of surgical patent ductus arteriosus (PDA) closure, and to evaluate the feasibility of transcatheter PDA closure using Amplatzer device Methods From April 1999 to July 2000, sixty nine patients (18 males, 51 females) underwent surgical closure of PDA, and one hundred and eleven patients (48 males, 63 females) underwent transcatheter PDA closure using Amplatzer device The costs and effectiveness of both methods were compared Results The technical success rate was 98 2% (109/111) in Amplatzer group and there were no complications The two unsuccessful patients then underwent surgical closure in other days All patients in surgery group were treated successfully without death Major complications were pulmonary atelectasis in 7 patients, pneumothorax in 4, coronary air embolism in 1, cardiac arrest in 1, injury of recurrent laryngeal nerve in 2, and postoperative recanalization in 1 Twelve patients were transfused 200 800 ml blood [mean (483 3±216 7) ml] The mean total cost was significantly higher for Amplatzer device closure than for surgery The mean professional fee was similar in both groups, but the mean material cost in Amplatzer group was higher than that in surgery group ( P <0 01) Conclusion Transcatheter closure of PDA using Amplatzer device is an alternative to surgery within acceptable limits The method would be applied widely if the cost of Amplatzer device was reduced
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2002年第7期387-389,共3页
Chinese Journal of Cardiology
基金
国家"九五"科技攻关项目 (96 92 0 0 6 0 5 2 4)
