动脉导管未闭封堵治疗途径个体化探讨

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。

Exploration of Individualization Approach for Transcatheter Closure of Patent Ductus Arteriosus

Objective To explore the approach and safety of transcatheter closure of patent ductus arteriosus （PDA） by using the home-made occluder.Methods A total of 182 patients with PDA admitted in Fujian Provincial Hospital from Mar.2001 to Jul.2012 were voluntarily enrolled in interventional therapy,who underwent transcatheter closure of PDA with home-made occluder via different approachs.The effect and complications were evaluated by transthoracic color doppler echocardiography at 24-48 hours,1-12 months after closure,respectively.Results The success rate of transcatheter closure was 97.8％ （178/182） in the study.The technical success rate was 97.9％ （143/146）,100％ （22/22）,92.9％ （13/14） through the conventional approach,femoral artery-PDA-pulmonary artery-femoral vein wire-track approach and the single venous approach,respectively.All the patient was infant in the single venous approach group.There were no severe complications at 24-48 hours after closure or during 1-12 months of follow-up in all successful cases.Conclusion Transcatheter closure of PDA with the home-made occluder is safe with reliable curative efficacy.The choice of interventional approach should be decided appropriately according to the clinical individual manifestations.