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目的观察动脉导管未闭(PDA)封堵术后1周患者心血管系统超声变化,探讨其临床意义。方法收集2008—2010年中国医科大学附属第一医院行内科PDA经导管封堵术患者40例,根据术前左室舒张期末内径(LVDD)分为A组(LVDD≥55 mm)、B组(LVDD<55 mm);根据术前肺动脉平均压(PAMP)分为Ⅰ组(PAMP<25 mmHg)、Ⅱ组(25 mmHg≤PAMP<50 mmHg)、Ⅲ组(PAMP≥50 mmHg)。对比研究其术前和术后1周经胸超声心动图(TTE)变化。结果 (1)术后升主动脉内径/肺动脉内径比值由1.11±0.22增至1.21±0.25(P=0.0231);术后主动脉瓣流速由(1.77±0.69)m/s减至(1.46±0.54)m/s(P=0.0467),左房内径由(40.13±6.44)mm减至(36.05±6.28)mm(P=0.0027),LVDD由(59.58±10.20)mm减至(54.40±9.19)mm(P=0.0098)。(2)LVDD不同患者术后1周左心房、左心室均明显缩小,差异有统计学意义。LVDD较大组差异更显著。(3)PAMP不同患者术后1周左心房、左心室均明显缩小,Ⅰ组差异有统计学意义,Ⅱ组差异有统计学意义,Ⅲ组差异无统计学意义。结论能耐受PDA封堵术的患者均能在术后早期开始获益,术前LVDD较大组和PAMP<25 mmHg组获益最大。
Objective To observe the changes of cardiovascular system in patients with patent ductus arteriosus (PDA) one week after closure of PDA, and to explore its clinical significance. Methods Forty patients with PDA underwent catheterization at the First Affiliated Hospital of China Medical University from 2008 to 2010 were divided into group A (LVDD≥55 mm), group B ( (PAMP <25 mmHg), group Ⅱ (25 mmHg≤PAMP <50 mmHg) and group Ⅲ (PAMP≥50 mmHg) according to preoperative pulmonary artery mean pressure (PAMP). Comparative study of its preoperative and postoperative 1 week transthoracic echocardiography (TTE) changes. Results (1) The ratio of ascending aorta diameter to pulmonary artery diameter increased from 1.11 ± 0.22 to 1.21 ± 0.25 (P = 0.0231) after operation. The aortic valve velocity decreased from 1.77 ± 0.69 m / s to 1.46 ± 0.54 ) in the left atrium decreased from (40.13 ± 6.44) mm to (36.05 ± 6.28) mm (P = 0.0027) and the LVDD decreased from (59.58 ± 10.20) mm to (54.40 ± 9.19) mm (P = 0.0098). (2) Left atrium and left ventricle were significantly reduced in different LVDD patients at 1 week after operation, the difference was statistically significant. LVDD larger group more significant difference. (3) The left atrium and left ventricle in different PAMP patients were significantly reduced after 1 week. The difference between the two groups was statistically significant. The difference between the two groups was statistically significant. The difference between the three groups was not statistically significant. Conclusions All patients who can tolerate PDA occlusion can benefit early after surgery. The patients with preoperative LVDD and PAMP <25 mmHg benefit the most.