小儿动脉导管未闭介入治疗随诊的超声心动图分析

目的 应用彩色多普勒超声心动图（CDFI）比较经导管五种方法堵闭小儿动脉导管未闭（PDA）的疗效。方法 1989年3月－1999年7月，超声心动图分别观察采用海绵塞（Porstman）、双面伞堵闭器（Rashkind0、纽扣式补片（Sideris）、弹簧圈闭(Coil）和蘑菇伞堵闭塞(Amplatzer）堵闭282例PDA患儿术前、术后1天、3个月、6个在动脉水平有无分流、心脏大小变化、闭器的位置及其血流动力学的改变。结果 5组患儿术后1天左室舒张末径（LVDD）和左房径（LA）明显缩小（P＜0.001），6个月基本恢复正常；术后1天残余分流17％、3个月下降至6.4%。6个月无进一步下降。结论 Amplatzer和Coil闭法分别闭对小于或等于8.1mm和2.5mm的PDA远期疗效确切，已基本能替3代手术结扎的方法，值得在临床推广。

CDFI evaluation of five different transcatherter closure methods for PDA

Objective To evaluate the 5 different transcatherter closure methods for PDA. Methods From March 1989 to July 1999, 282 cases underwent 5 different interventional closure methods (porstman's, rashkind's, sideris's, coil's and amplatz's) for PDA. CDFI evaluation has been conducted before procedure, and 1 day up to 6 months after procedure. The study included diameter of LA, LVDD, and the displacements of device, residual flow and changes of hemodynamics. Results LA, LVDD decreased significantly in all of 5 groups ( P<0.001 ). They became almost normal in 6th month late after procedure. The residual flow in the main PA were 17%, 6.4 % and keep the same respectively at 1 day, 3 months, 6 months late after procedure. Conclusion Effects of interventional closure methods (coil's and amplatz's) for PDA which was smaller than or was equal to 8.1 mm and 2.5 mm are favorable in short and long term follow up by CDFI, they replaced essentially surgical treatment.