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1.
目的 对堵闭器与开胸结扎术治疗动脉导管未闭(PDA)的疗效及安全性进行对比研究.方法 对32例PDA患儿在透视监视下经导管置入堵闭器封堵PDA,术后30分钟行主动脉弓降部造影,术后分别行彩色超声心动图、胸片、心电图等随访观察;与行开胸结扎术的24例PDA患儿做比较.结果 介入组与开胸组治疗成功率均达100%.结论 介入组痛苦更少,恢复更快,并发症更少且无需输血治疗.  相似文献   

2.
[目的]评价Amplatzer堵闭器对动脉导管未闭(PDA)的治疗效果.[方法]应用Amplatzer堵闭器和主动脉造影及6F长鞘输送器置入Amplatzer堵闭器,治疗11例动脉导管未闭患者.[结果]堵闭成功率100%;随访2月~1年,全部病例无残余分流和任何并发症.[结论]应用Amplatzer堵闭器治疗PDA操作简便,安全,有效.  相似文献   

3.
 [目的]对比研究Amplatzer堵闭器(ADO)与外科手术治疗动脉导管未闭(PDA)的疗效,探讨ADO治疗PDA的临床价值.[方法]1998年11月-2004年1月在我院采用Amplatzer堵闭器介入治疗的PDA患者31例,同期采用外科手术法治疗的PDA患者32例.采用病例对照研究的方法,比较两种方法的疗效、主要并发症等.[结果]两种疗法的成功率(介入组93.3%、外科组100%)、主要并发症发生率(介入组14.3%、外科组12.5%)无显著性差异(P>0.05).外科组接受输血、呼吸机辅助通气各8例,介入组无1例接受输血和呼吸机辅助通气;术后住院时间介入组2~7(4.7±1.4)d,外科组7~23(10.9±3.5)d.两组比较均有显著性差异(P<0.05).[结论]Amplatzer法治疗PDA安全可靠,疗效与外科手术相似,较外科方法创伤小、术后住院时间短,在适应证范围内,可作为治疗PDA的合适方法.  相似文献   

4.
Amplatzer堵闭器治疗动脉导管未闭11例临床观察   总被引:3,自引:1,他引:2  
[目的]评价Amplatzer堵闭器对动脉导管未闭(PDA)的治疗效果。[方法]应用Amplatzer堵闭器和主动脉造影及6F长鞘输送器置入Amplatzer封闭器,治疗11例动脉导管未闭患。[结果]堵闭成功率100%;随访2月-1年,全部病例无残余分流和任何并发症。[结论]应用Amplatzer堵闭器治疗PDA操作简便,安全,有效。  相似文献   

5.
动脉导管未闭(PDA)是最常见的先天性心脏病之一,目前的治疗方法主要有介入封堵术、开胸结扎术、胸腔镜手术、体外循环手术等.我院2006年6月至2010年6月对108例患者采用腋窝小切口施行动脉导管未闭(PDA)结扎术,效果良好,现报告如下.  相似文献   

6.
目的比较国产动脉导管未闭封堵器与Amplatzer动脉导管未闭封堵器(amplatzer duct occluder,ADO) 治疗动脉导管未闭(PDA)的疗效、安全性及费用。方法对80例接受PDA封堵术的患儿进行回顾性分析,其中国产器械组50例,ADO组30例,比较两种方法的疗效、并发症及费用。结果两组技术成功率比较差异无显著性(100% vs 98%,P>0.05)。即刻完全封堵率国产器械组明显高于ADO组(75% vs 43%,P<0.05),但术后24 h,1, 3,6,12个月不同时间点随访完全封堵率两组差异无显著性(P>0.05)。国产器械组并发症1例(2%),ADO组并发症2例(6.7%),两组比较差异无显著性(P>0.05)。国产器械组住院费用明显低于ADO组[(29 457.54±220.36)元vs (39012.65±143.73)元](P<0.001)。两组均无死亡病例。结论国产动脉导管未闭封堵器与ADO 疗效、并发症均无明显差异,但应用国产器械费用明显低于ADO,值得推广应用。  相似文献   

7.
自Porstmann等应用Ivalon海绵塞子堵闭动脉导管未闭(PDA)获得成功以来,应用介入疗法堵闭PDA技术已在国内外广泛开展,如Rashkind等型堵闭器、Sideris纽扣式补片、弹簧圈、Amplatazer蘑菇伞等.治疗效果良好,术后残余分流也多在1~3个月后消失,但术后可发生急性溶血常需紧急外科手术或第2次行介入弹簧圈堵闭术[1].我们于2001年5~7月,对采用Amplatzer房间隔堵闭器堵闭巨大PDA术后急性溶血的 2例患者,进行积极的内科处理,取得了良好的治疗效果,现报告如下.  相似文献   

8.
[目的]探讨胸腔镜辅助胸膜外动脉导管未闭结扎术的临床应用价值.[方法]回顾性总结分析我院8年来实施胸腔镜辅助胸膜外动脉导管未闭结扎术51例患者的临床资料,并查阅近8年来国内外传统开胸PDA结扎术;腋下小切口PDA结扎术:胸腔镜PDA钳闭术及Amplatzer封堵器PDA封堵术的相关文献,对获得的相关临床资料与本术式进行对比分析.[结果]共查阅国内外相关文献351篇,各相关临床资料经统计学处理后,显示本术式与其他四种术式总并发症事件发生率比较,差异无统计学意义(P>0.05).传统开胸PDA结扎术;腋下小切口PDA结扎术、胸腔镜PDA钳闭术、Amplatzer封堵器介入PDA封堵术和本术式的PDA治疗直径(mm)适应范围分别为2~20、3~16、3~10、4~12和2~20;治疗后残余分流率(%)分别为0.92~1.4、0~0.39、0.60~3.08、1.40~2.43、2.1;再次手术发生率(%)分别为0.39~0.91、0.39、0~2.31、0~0.59和0;年龄(岁)时应范同分别为0.9~56、5~24、1~36、3~60和1.5~38;住院日(d)分别为9~14、3~5、3~5、1~3和3~5;平均治疗费用(元)分别为12 486、6 042、9 781、34 169和10 230;死亡率(%)分别为0~0.56、0、0、0和0.[结论]本术式疗效与常规开胸手术相同,但创伤小,恢复快;在PDA治疗直径和年龄适应范围较腋下小切口、单纯的胸腔镜手术及Amplatzer封堵术广,治疗费用明显低于Amplatzer封堵术.  相似文献   

9.
目的:总结分析我院近年来实施胸腔镜下动脉导管未闭结扎术16例患者的临床资料,通过探讨胸腔镜下动脉导管未闭结扎术外科治疗的临床研究,从而提供动脉导管未闭外科治疗的适宜方法。方法:手术采用传统常规右侧卧位,胸壁选取适宜胸腔镜插入与操作切口,胸腔镜下分离PDA周围组织结构后,选取尼龙夹夹闭未闭合的动脉导管,术毕安置胸腔引流管,缝合切口,术后及复查时行心脏彩超检查以确定效果。结果:胸腔镜下PDA尼龙夹夹闭术平均手术时间较短,术中及术后出血量较少,心脏杂音消失,心脏彩超提示未闭PDA血流信号消失。结论:胸腔镜下PDA尼龙夹夹闭术较传统开胸PDA结扎术、胸腔镜PDA钛夹钳闭术、介入封堵术效果较好且并发症较少。  相似文献   

10.
儿童动脉导管未闭介入堵闭术的临床疗效评价   总被引:1,自引:0,他引:1  
目的评价分别运用弹簧圈(Coil)和Amplatzer封堵器(ADO)堵闭小型和中一大型动脉导管未闭(PDA)的临床疗效。方法对1998年5月至2006年1月在我院接受介入封堵术的112名PDA患儿进行回顾性队列研究。结果植入Coil和ADO的患儿分别为19例和93例。AIX)组患儿PDA最窄处直径为1.7~11.0mm,(平均3.53mm),显著高于Coil组患儿1.0~3.3mm(平均1.76mm),P〈0.001。全部患儿均成功完成介入封堵术(100%)。1年随访期中,残余分流率在不同随访时间点分别为Coil组31.6%(即刻)、26.3%(24h)、5.3%(1~3月)、5.3%(9~12月)和ADO组21.5%、6.5%、2.2%和1.2%。近期并发症2例,溶血1例,心律失常1例。远期随访中无溶血、PDA再通和左肺动脉或降主动脉狭窄;无患儿因残余分流需要再次接受介入治疗。结论选择合适的堵闭器经导管介入封堵治疗儿童PDA疗效确切,安全性好。  相似文献   

11.
经导管封堵治疗儿童动脉导管未闭   总被引:1,自引:0,他引:1  
目的:观察不同封堵器治疗儿童动脉导管未闭(patentductusarteriosus,PDA)的结果。方法:体检及经胸二维超声心动图(trans-thoracicechocardiograph,TTE)诊断为PDA的儿童,用原所报道过的方法作心导管检查、降主动脉造影及PDA封堵术。0.7~14岁的儿童行封堵术者78例,其中行螺旋弹簧(coil)治疗者16例;行Amplatzerductoccluder(ADO)治疗者9例;行国产PDA封堵器治疗者53例。结果:78例封堵成功,术后次日TTE检查,76例PDA完全堵塞,2例用coil堵塞者有少量残余分流。术前64例左室舒张末期内径增大者术后明显缩小。用ADO和PDA封堵器堵塞的62例无残余分流。3月末TTE检查,77例PDA完全堵塞,左室内径完全正常,1例用coil堵塞者仍有少量残余分流,且持续4年以上。追踪3~80平均(30±8)月,77例PDA完全堵闭,左室大小正常,降主动脉、左肺动脉口无明显狭窄,无封堵器械脱落。结论:用ADO,国产PDA封堵器和coil可安全有效地治愈儿童PDA。因创伤小,并发症少,远期无不良反应,可替代开胸手术。  相似文献   

12.
目的 应用Amplatzer封堵器治疗动脉导管未闭 (patentductusarteriosus ,PDA)并评价其临床疗效。 方法  7例患者 ,女 2例 ,男 5例 ,年龄 2 .5~ 5 6岁 ,体重 10 .0~ 73 .5kg ,均经超声心动图确诊。术中行右心导管测压后 ,进行主动脉弓降部造影 ,以确定PDA的位置、形状及最窄直径。选择大于所测PDA最窄直径 3~ 6mm的封堵器 ,于透视下经输送鞘管将其封堵于PDA处。 10分钟后重复造影 ,若封堵器形状、位置满意 ,无或仅有微~少量残余分流时 ,可释放封堵器。术后 1周 ,1~ 6个月行超声心动图、心血管摄片检查 ,观察残余分流情况、封堵器位置及心脏大小的变化。结果 主动脉弓降部造影显示PDA均呈管型 ,PDA最窄直径平均为 5 .5± 3 .1mm ( 3 .0~ 11.8mm )。均有肺动脉高压 ,其中轻度 6例 ,重度 1例。 7例封堵器均放置成功。造影示 6例即刻完全封堵 ,1例有微量残余分流 ,此患者术后 18小时发生急性溶血 ,经内科保守治疗治愈 ,术后 1个月彩色多普勒超声心动图示残余分流消失 ,随访 6个月 7例患者心脏均有不同程度缩小。结论 应用Amplatzer封堵器治疗PDA是一种方法简便 ,成功率高 ,近期疗效可靠的介入方法  相似文献   

13.
吴志勇  关瑞锦  蒋辉  陈斌  卢荔红 《医学综述》2014,20(20):3808-3810
目的探讨国产封堵器介入治疗动脉导管未闭(PDA)途径及其安全性。方法选择2001年3月至2012年6月福建省立医院自愿行介入治疗的PDA患者182例作为研究对象,患者经不同途径行介入封堵术,经胸心脏彩色多普勒超声评价术后2448 h的封堵结果及随访148 h的封堵结果及随访112个月后并发症的发生情况。结果本研究封堵技术成功率为97.8%(178/182),经常规途径封堵技术成功率为97.9%(143/146);经动静脉轨道途径封堵技术成功率为100%(22/22);经单静脉途径封堵的患者均为婴幼儿,技术成功率为92.9%(13/14)。封堵成功患者术后2412个月后并发症的发生情况。结果本研究封堵技术成功率为97.8%(178/182),经常规途径封堵技术成功率为97.9%(143/146);经动静脉轨道途径封堵技术成功率为100%(22/22);经单静脉途径封堵的患者均为婴幼儿,技术成功率为92.9%(13/14)。封堵成功患者术后2448 h及148 h及112个月均无主要并发症发生。结论应用国产封堵器介入封堵PDA疗效可靠、安全,但应根据患者不同的情况酌情选择介入途径封堵。  相似文献   

14.
R啨sum啨   Objectif Explorerl efficacit啨delafermeturetranscath啨t啨riennedelapersistanceducanalart啨riel (PCA )aveclaspire (coil)d啨tachableetaveclebloqueurAmplatzer (Amplatzerductoccluder,ADO) ,discuterlesfacteursimpliqu啨s . M啨thodes Lafermeturetranscath啨t啨rienne…  相似文献   

15.

Background:

Percutaneous closure of patent ductus arteriosus (PDA) with Amplatzer duct occluder (ADO) has become increasingly popular in many cardiovascular centres. This study analysed the long-term results of percutaneous closure of PDA with ADO in a single centre.

Materials and Methods:

Between May 2004 and January 2013, 243 patients with median age of 2.5 years (range = 30 months to 38 years) and median weight of 10 Kg (range 4.5–80.5 Kg) underwent percutaneous closure of PDA using the ADO. The devices were implanted under fluoroscopic guidance. Patients were followed-up for any complications.

Results:

The mean diameter of narrow part of PDA was 6.4 ± 2.2 mm. The mean diameter of devices was 7.8 ± 2.3 mm. The devices were successfully implanted in 239 (98.3%) cases. At immediate, 1 day, 1, 6, 12 months and late follow-up, the complete occlusion rate was 33% (79 case), 97.1% (236 case), 97.5% (237 case), 98.3% (238 case), 98.3% (238 case) and 98.3% (238 case), respectively. Residual shunt remained in one case at late follow-up. The device embolisation occurred in five patients. The devices were successful retrieved in three patient and second larger devices were inserted. Two other devices were surgically retrieved and PDAs were ligated. Moderate left pulmonary artery stenosis (LPA) in one child and mild LPA stenosis in one infant were detected. Mild aortic obstruction occurred in one infant.

Conclusions:

Long-term follow-up of patients indicate that percutaneous closure of PDA using ADO is a safe and effective procedure. However, some complications, including device embolisation, left pulmonary stenosis and aortic obstruction may be observed in some cases.  相似文献   

16.
目的 对继发孔房间隔缺损 (ASDⅡ )的Amplatzer间隔封闭器 (ASO)介入和外科治疗的疗效和安全性进行比较研究。方法  1998年 5月~ 2 0 0 2年 12月接受ASO治疗的 72例和接受外科手术治疗的 6 6例ASDⅡ病人进行对比研究。结果 ASO组和外科组技术成功率分别为 97.2 % (70 /72例 )和 10 0 % ;ASO组的手术和住院时间明显短于外科组 (71.8± 11.6 )min和 (15 8.4± 31.8)min ;(8.8± 2 .3)d和 (2 6 .9± 9.9)d ,(P<0 .0 5 ) ;ASO组的手术并发症发生率明显低于外科组 (7.1%和 2 2 .7% ,P <0 .0 5 ) ;ASO组无病人接受输血 ,外科组接受输血率 89.1% (5 9/6 6例 ) ;ASO组费用明显高于外科组 (4 .4 5± 0 .5 3)万元和 (1.87± 0 .5 4 )万元 ,(P <0 .0 5 )。结论 继发孔ASD的ASO治疗在有适应症的范围内可替代外科手术 ,降低ASO费用有助于更广泛推广作用。  相似文献   

17.
Background Transcatheter Amplatzer occlusion of patent ductus artertiosus (PDA) has emerged as a minimally invasive alternative to surgical closure. The goal of this study was to compare long-term clinical outcomes between two procedures, especially on chronic residual shunt, late or very late procedure-related complications, and regression of pulmonary hypertension and left ventricular dilation.
Methods A total 255 patients having isolated PDA with a minimal diameter of ≥4 mm treated from January 2000 to July 2003 were included in this study and have been followed up until July 2008. The patients were assigned to either the device or surgical closure group according to the patients' and/or their parents' preference. Baseline physical exams, chest roentgenography, electrocardiography, and echocardiography were performed preprocedure and at each follow-up. Results Seventy-two patients accepted the transcatheter procedure (Group-TC) and 183 underwent surgical operation (Group-SO) for PDA closure, both groups were similar in their demographics and preoperative clinical characteristics. There were no cardiac deaths and late complications such as infectious endocarditis and Amplatzer duct occluder (ADO) dislodge in either group. More acute procedure-related complications were recorded in Group-SO (13.7%) compared with Group-TC (1.4%) (P=0.004). The recovery time was (8.7±2.3) days for the Group-SO and (1.3+0.5) days for the Group-TC (P〈0.001). The survival freedom from persistent residual shunt, defined as residual shunt that can not resolve automatically, was 91.3% for Group-SO and 98.6% for Group-TC (P=0.037 by Log-rank test). There was no significant difference in regression of pulmonary hypertension and left ventricular dilation; neither survival freedom from pulmonary hypertension nor abnormal left ventricular end-diastolic volume index were significantly different between the surgical group and the Amplatzer group.
Conclusions Our study confirmed the long-term safety and efficacy of transcatheter Amplatzer occlusion. In comparison to the time-proven surgical closure, transcatheter Amplatzer occlusion was less invasive and associated with fewer complications and residual shunt, and as effective in the regression of pulmonary hypertension and left ventricular dilation.  相似文献   

18.

Background:

Patent ductus arteriosus (PDA) is one of the most common congenital heart diseases and began to get treated by transcatheter occlusion since 1997 in China. Since then, several devices have been invented for occluding PDA. This study aimed to evaluate the technical feasibility, safety, and efficacy of transcatheter occlusion of PDA with different devices.

Methods:

One thousand five hundred and twenty-six patients (537 boys, 989 girls) with PDA from January 1997 to September 2014 underwent descending aortogram and transcatheter occlusion procedure. We retrospectively analyzed data of these patients, including gender, age, weight, size and morphology of PDA, and devices used in transcatheter occlusion, outcomes, and postoperational complications.

Results:

Median age and median weight were 4.0 years (range: 0.3–52.0 years old) and 15.3 kg (range: 4.5–91.0 kg), respectively. Mean ductal diameter, aortic ductal diameter, ductal length, and pulmonary artery pressure were 3.50 ± 2.15 mm, 10.08 ± 2.46 mm, 7.49 ± 3.02 mm, and 30.21 ± 17.28 mmHg, respectively. Morphology of PDA assessed by descending aortogram was of type A in 1428 patients, type B in 6 patients, type C in 79 patients, type D in 4 patients, and type E in 9 patients according to the classification of Krichenko. Of all the 1526 patients, 1497 patients underwent transcatheter PDA closure, among which 1492 were successful. Devices used were Amplatzer duct occluder I (ADO I, 1280, 85.8%), Cook detachable coils (116, 7.8%), ADO II (ADO II, 68, 4.6%), muscular VSD occluder (12, 0.8%), and Amplatzer vascular plug (16, 1.0%).

Conclusions:

Excellent occlusion rates with low complication rates were achieved with all devices regardless of PDA types. With transcatheter occlusion technique and devices developing, more patients with PDA can be treated with transcatheter closure both safely and efficiently.  相似文献   

19.
①目的 探讨经导管先天性心脏病封堵术的可行性及安全性,进行多因素综合疗效评价。②方法通过经胸超声心动图(TTE)选择适合封堵术的先天性心脏病病人46例,其中房间隔缺损(ASD)20例,室间隔缺损(VSD)19例,动脉导管未闭(PDA)7例。在TTE及X线引导下行介入封堵术,术后通过TTE进行动态的随访观察。③结果 46例病人全部封堵成功,技术成功率为100%;术后5 例病人有微量至少量残余分流;1 例出现阵发性房颤,1例出现一过性完全性右束支传导阻滞(RBBB),无其他严重并发症发生。ASD、VSD及PDA术前TTE测量值与术中X线测量值比较无显著性差异(t=0.222~1.136,P>0.05)。术后50%以上病人接受了3~6 个月随访。④结论 经导管先天性心脏病封堵术具有很高的成功率及安全性;介入封堵术疗效好、并发症少、术后恢复快;TTE可以准确地应用于先天性心脏病封堵术中。  相似文献   

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