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目的通过对蘑菇伞型封堵器介入法治疗动脉导管未闭(PDA)临床疗效的分析,以总结经验,提高成功率。方法行主动脉弓降部侧位造影,了解PDA形态、位置,测量PDA最窄处直径。按较所测PDA最窄处直径大3~4mm的原则选取封堵器,采用Amplatzer法对PDA进行封堵治疗。并对合并的室间隔缺损、房间隔缺损及主动脉缩窄等同时进行介入治疗。结果本组122例患者,年龄(15.6±10.7)岁(1~70)岁,体重6~66(28.2±18.6)kg。PDA最窄处直径2.5~12.0(5.8±2.7)mm。122例中120介入治疗获得成功(成功率98.4%),1例极细小PDA放弃治疗,1例反漏斗型PDA转外科手术。无手术相关并发症,术后随访1~12个月,未见残余分流、再通及封堵器移位。结论采用蘑菇伞型封堵器对PDA进行介入治疗操作方便、安全、有效,可以取代外科手术治疗。
Objective To summarize the experience and improve the success rate by analyzing the clinical efficacy of mushroom umbrella occluder in the treatment of patent ductus arteriosus (PDA). Methods Aorta arch side of the lesion angiography, PDA morphology, location, measuring the narrowest diameter PDA. PDA was measured by the narrowest diameter of 3 ~ 4mm larger than the principle of selection of occluder, PDA closure using Amplatzer method. And the combined ventricular septal defect, atrial septal defect and aortic stenosis at the same time for interventional therapy. Results A total of 122 patients (aged 15.6 ± 10.7 years (range, 1 to 70) years old, weighing 6 to 66 (28.2 ± 18.6) kg) were enrolled in this study. PDA narrowest diameter 2.5 ~ 12.0 (5.8 ± 2.7) mm. In 122 cases, 120 interventional treatments were successful (success rate was 98.4%), 1 case of small PDA gave up treatment and 1 case of inverted funnel PDA was operated on. No surgical complications, follow-up 1 to 12 months after surgery, no residual shunt, and then through and occluder displacement. Conclusion The use of mushroom umbrella occluder PDA for interventional treatment is convenient, safe and effective and can replace the surgical treatment.