关于婴幼儿动脉导管未闭介入治疗的临床研究

目的：探讨Amplatzer法介入封堵治疗婴幼儿动脉导管未闭（PDA）的经验，治疗意义，操作技术及安全性。方法：回顾性分析32例婴幼儿PDA患儿资料，患儿年龄≤3岁，平均（13±5．5）月，体重（10．3±4．2）kg；做右心导管，实行封堵术，术后24h，1、3、6、12月复查超声心动图。结果：32例患儿中29例（90．6％）封堵成功，PDA最窄处直径（4．2±2．1）mm。失败者2例为PDA封堵器主动脉侧过大，导致降主动脉局部狭窄、迂曲变形而放弃封堵，1例封堵术后封堵器周围大量残余分流，行外科手术治疗。并发症包括术后残余分流、股动脉搏动减弱及伤口出血等。结论：在严格选择适应证的条件下，介入封堵婴幼儿动脉导管未闭较为安全，可行。

Clinical research in intervention therapy of patent ductus arteriosus in infant

Objective： To explore the significance, operation and security of transcatheter occlusion of patent ductus arteriosus （PDA） in infant. Methods： The retrospective analysis of data of process of transcatheter occlusion of 32 PDA patients in infant were performed. They were aged ≤3 year, the mean age was （13±5.5） months, meanwhile the mean weight was （10.3±4. 2） kg. Firstly, cardiac catheterization was practiced, then closed PDA with suitable occluder. Last, echocardiogram was used to estimate the result on 24h, 1, 3, 6, 12 - month. Results： The occlusion of 29 cases （90.6%） were successful, among which the most stenotic diameter of PDA was （4.2±2. 1） mm. In two children transcatheter occlusions were failure because descending aorta was stenosis caused by large occluder. And one case was practiced surgery because of mass residual shunt around the blockage. The complication included residual shunt, weak beating of femoral artery and haemorrhage. Conclusion： Transcatheter occlusion of patent ductus arteriosus is safe and feasible while the indication selecting is rigorous.