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目的:评价经导管介入封堵治疗动脉导管未闭(PDA)的疗效和安全性。方法:对接受经导管介入封堵术的175例PDA患者进行观察,行X线胸片,经胸超声心动图检查评价患者术后即刻封堵结果、心功能变化及并发症发生情况。结果:175例随访时间为术后1～77个月。封堵后即刻有9例(5.14%)存在微量分流,3例(1.71%)降主动脉或肺动脉血流增快。1个月随访时,未见残余分流。3例血流增快者在随访1～5年后血流降至正常。术后1周与术前相比心脏重塑明显改善,左房内径、左室收缩末内径、左室舒张末内径、左室收缩末容积、左室舒张末容积、左室每博搏出量封堵前分别为(31.6±7.8)mm,(33.0±7.6)mm,(51.6±10.6)mm,(40.3±19.5)ml、(118.6±32.5)ml、(77.7±38.1)ml;封堵后1周降分别为(29.4±6.6)mm,(30.8±6.7)mm,(47.5±9.2)mm、(34.6±19.0)ml、(80.3±29.6)ml、(64.5±31.1)ml(P<0.05)。术后1个月与1周相比无明显变化。随访期间没有出现死亡病例或其他严重并发症。结论:应用介入封堵治疗PDA能改善患者的心功能,中远期疗效确切,安全性好。
Objective: To evaluate the efficacy and safety of transcatheter closure of patent ductus arteriosus (PDA). Methods: A total of 175 PDA patients who underwent catheterization and interventional therapy were observed. X-ray and transthoracic echocardiography were used to evaluate the immediate postoperative occlusion, cardiac function changes and complications. Results: The follow-up time of 175 cases was 1 to 77 months after operation. Immediately after the occlusion, there were 9 cases (5.14%) with slight diversion, and 3 cases (1.71%) with accelerated descending aorta or pulmonary artery. One month follow-up, no residual shunt. 3 cases of blood flow faster follow-up 1-5 years after the blood flow to normal. One week after operation, cardiac remodeling was significantly improved compared with that before operation. Left atrium diameter, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, left ventricular end-systolic volume, left ventricular end-diastolic volume, (31.6 ± 7.8) mm, (33.0 ± 7.6) mm, (51.6 ± 10.6) mm, (40.3 ± 19.5) ml, (118.6 ± 32.5) ml and (77.7 ± 38.1) ml respectively after occlusion; (P <0.05) were significantly lower than those in the control group (29.4 ± 6.6 mm, 30.8 ± 6.7 mm, 47.5 ± 9.2 mm, 34.6 ± 19.0 ml, 80.3 ± 29.6 ml, 64.5 ± 31.1 ml, ). There was no significant change at 1 month and 1 week after operation. No deaths or other serious complications occurred during follow-up. Conclusion: The application of occlusion and treatment of PDA can improve cardiac function in patients with long-term curative effect and safety.