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中国临床研究英文版:2018,31(3):335-339
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经胸超声引导下不同封堵器介入封堵治疗动脉导管未闭的应用
(1.昆明医科大学第一附属医院心脑血管科,云南 昆明 650032;2.云南省罗平县医院心脑血管科,云南 曲靖655800)
Different occluders in transthoracic ultrasound-guided interventional occlusion in the treatment of patent ductus arteriosus
摘要
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Received:August 30, 2017   Published Online:March 20, 2018
中文摘要: 目的 探讨不同封堵器在经胸超声引导下动脉导管未闭(PDA)介入封堵中的应用效果。方法 回顾分析2014年2月至2017年2月接诊的72例PDA患者的临床资料,按照封堵方式不同分为观察组(Amplatzer型封堵器)43例和对照组(弹簧圈封堵器)29例,比较两组封堵治疗效果。结果 观察组及对照组患者封堵成功率分别为97.67%和89.66%,其中完全阻闭分别为95.35% 与79.31%,差异无统计学意义(P>0.05)。两组患者术后1个月、3个月左房内径(LAD)、左室舒张末期内径(LVEDD)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室每搏量(LVSV)水平均明显低于术前(P<0.05),但两组间差异无统计学意义(P>0.05)。观察组患者封堵直径明显高于对照组[(4.01±0.86)cm vs (1.72±0.48)cm,P<0.01]。两组患者手术时间、封堵操作时间差异无统计学意义(P>0.05)。两组患者术后肺动脉收缩压、肺动脉平均压、主动脉压水平、术后并发症总发生率对比,差异无统计学意义(P>0.05)。结论 Amplatzer型封堵器与弹簧圈封堵器在介入封堵PDA中均有良好的效果,可根据临床实际情况进行选择。
Abstract:Objective To investigate the application and effect of different occluders in transthoracic ultrasound-guided interventional occlusion in the treatment of patent ductus arteriosus (PDA).? Methods According to the occlusion method, a total of 72 PDA patients were divided into observation group (Amplatz canine duct occluder, n=43) and control group (coil occluder, n=29). The occlusion effect was compared between two groups.? Results There was no significant difference in successful rate of occlusion in the observation group and the control group (97. 67% vs 89. 66%). The complete closure rate was 95. 33% in the observation group and 79. 31% in control group, respectively. The left atrium diameter (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular stroke volume (LVSV) in both two group at 1 and 3 month(s) after the operation were significantly lower than those at pre-operation (all P<0.05), but showed no difference between two groups (all P>0.05). The occlusion diameter in observation group was higher than that in control group [(4. 01±0.86)mm vs (1.72±0.48)mm, P<0.01] . There were no significant differences in surgery time and occlusion operation time intra-operationly and in level of pulmonary artery systolic pressure, mean pulmonary artery pressure, aortic pressure and total incidence complications in two groups post-operationly.? Conclusion Both Amplatz canine duct occluder and coil occluder has a good effect in PDA closure which should be chosen according to clinical condition.
文章编号:     中图分类号:R 654.2    文献标志码:A
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