介入治疗动脉导管未闭伴肺动脉高压患儿的临床研究

目的 探讨国产封堵器治疗动脉导管未闭（PDA）伴不同程度肺动脉高压（PAH）患儿的临效果.方法 选择30例动脉导管未闭合并轻中度肺动脉高压（PAMP≤50 mmHg,n=19）及重度肺动脉高压（PAMP＞50 mmHg,n=11）的患儿进行介入封堵治疗,在介入封堵术前及术后进行有创肺动脉压测定,并分别比较术前术后的肺动脉收缩压、舒张压及平均压的变化.结果 30例患儿均成功封堵,无死亡病例.两组患儿术前肺动脉收缩压、舒张压及平均压较术后均有明显下降,轻中度肺动脉高压组术后肺动脉压全部降至正常（P＜0.05）,重度肺动脉高压组术后肺动脉压有4例降至正常（P＜0.05）.结论 采用国产封堵器治疗儿童PDA合并肺动脉高压患儿安全有效.

Study of transcatheter closure of patent ductus arteriosus with severe pulmonary arterial hypertension

Objective To investigate the use of transcatheter closure in patients with patent ductus arteriosus with pulmonary arterial hypertension. Methods 30 PDA cases with pulmonary arterial hypertension were treated, one group was mild - to - moderate pulmonary arterial hypertension （PAMP ≤ 50 mmHg, n = 19）, and the other group was severe pulmonary arterial hypertension （PAMP 〉 50 mmHg,n = 11 ）. All the patients underwent transcatheter closure by using Amplatzer device. The PAMP （ systolic pressure, diastolic pressure and mean blood pressure） of both groups were compared in preoperative and postoperative. Results There was no one died in all 30 patients. Systolic pulmonary arterial pressure （systolic pressure, diastolic pressure and mean blood pressure） decreased signifi-cantly before and after closure. The pulmonary artery pressure of mild - to - moderate pulmonary hypertension group all down to normal （ P 〈 0.05 ）, and there were 4 patients with severe pulmonary hypertension became normal after surgery. Conclusion Anterograde transcatheter closure by using the China - made occluder device is a safe and effective interventional therapy for patent ductus arteriosus with pulmonary arterial hypertension patients.