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目的 对比研究Duct Occlud封堵器和Cook可控弹簧栓子治疗直径≤ 4mm动脉导管未闭 (PDA)的疗效。方法 1996年 4月至 2 0 0 2年 8月 ,4 2例直径 <2mm和 2 9例直径 2～ 4mm的PDA患者施行了Duct Occlud封堵器 (2 5例 )和Cook可控弹簧栓子 (4 6例 )封堵术。结果 (1)直径 <2mm的PDA行Duct Occlud封堵器和Cook可控弹簧栓子封堵后 10min、2 4h和 12个月残余分流率显著小于直径 2～ 4mm的PDA(分别为 4 8%与 6 2 0 % ,0与 37 9% ,0与 13 8% ;P均 <0 0 5 )。 (2 )Duct Oc clud封堵器治疗直径 2～ 4mm的PDA后 10min ,2 4h ,1和 12个月残余分流率显著高于Cook可控弹簧栓子组 (分别为 94 4 %与 9 1% ,6 1 1%与 0 ,4 4 4 %与 0 ,33 3%与 0 ;P均 <0 0 5 ) ,其中Duct Occlud封堵器脱落至腹主动脉远端 1例 ,向左肺动脉内凸出 4例 ;2例直径 2～ 4mm的PDA患者置入 2枚Cook可控弹簧栓子。结论 Duct Occlud封堵器和Cook可控弹簧栓子均是治疗直径 <2mmPDA的安全有效方法 ;Cook可控弹簧栓子封堵直径 2～ 4mm的PDA近、中期疗效优于Duct Occlud封堵器 ,但部分患者需置入 2枚栓子。
Objective To compare the efficacy of Duct Occlud occluder and Cook controllable spring embolus in the treatment of patent ductus arteriosus (PDA) of diameter ≤ 4 mm. Methods From April 1996 to August 2002, 42 Ductal Occlud occluders (25 cases) and Cook controllable spring emboli were performed in 42 patients with diameter <2 mm and 29 patients with diameter 2-4 mm (46 cases) closure surgery. Results (1) After 10 minutes occlusion of PDA Duct Occlud occluders and Cook controllable spring plugs with diameter less than 2mm, the residual shunt rates at 24 hours and 12 months were significantly smaller than those with 2-4 mm diameter PDA (P < With 6 2 0%, 0 and 37 9%, 0 and 13 8%; all P <0 05). (2) Duct Oc clud occluder 10min after 2 ~ 4mm diameter PDA, the residual shunt rates at 24h, 1 and 12 months were significantly higher than Cook controllable spring embolus group (94 4% and 91% , 6 1 1% and 0,44 4% and 0, 33 3% and 0; P <0 05). Among them, Duct Occlud occluder fell off to the distal abdominal aorta and left internal carotid artery Out of 4 cases; 2 cases of 2 ~ 4mm diameter PDA patients with two Cook controllable spring emboli. Conclusions Both Duct Occlud occluder and Cook controllable spring embolus are safe and effective methods for the treatment of diameter <2mmPDA. Cook controllable spring emboli block PDA with diameter of 2 ~ 4mm. The mid-term curative effect is better than Duct Occlud occluder, But some patients need to insert two emboli.