Amplatzer堵闭器与外科手术治疗动脉导管未闭的比较

目的对Amplatzer堵闭器(ADO)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21例PDA患儿在透视监视下经导管置入Amplatzer堵闭器封堵PDA,术后30 min行主动脉弓降部造影,术后24 h、1月、3月、6月及1年、2年、3年,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18例PDA患儿做比较.结果ADO介入组与开胸组治疗成功率均达100%.ADO介入组住院时间、术中失血量与开胸组比较均有显著减少,ADO介入组的手术并发症发生率明显低于开胸组.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;动脉导管未闭(PDA)的ADO介入治疗在有适应症的范围内可替代外科手术,值得在临床上推广应用.

Comparison between Amplatzer duct occluder and surgical closure on patent ductus arteriosus

Objective To compare the clinical efficacy and safety of interventional closure using Amplatzer duct occluder(ADO) with surgical closure of patent ductus arteriosus(PDA) in children.Methods 21 patients who underwent transcatheter PDA closure using ADO and 18 patients who underwent surgical closure of PDA were involved in the study.Patients underwent UCG,X-ray and ECG after 24 hours,1 month,3 months,6 months,1 year,2 years,3 years after the procedure.The efficacy and safety of both methods were compared.Results The success rate of the ADO group and the surgical group was 100%.The length of hospital stay and the lost of blood during the surgery of the ADO group were shorter than those of the surgical group.Conclusion The ADO group has less pain and recovers more quickly,with less complication than the surgical group.And it doesn't require transfusion. Transcatheter closure of PDA using ADO is an alternative to surgery at some extent.