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目的探讨Amplatzer第Ⅱ代动脉导管未闭封堵器(amplatzer duct occluderⅡ,ADOⅡ)栓塞幼儿体肺侧支的可行性及效果。方法入选2014年3月3日至2015年4月1日7例患儿(其中男6例,女1例)选用ADOⅡ栓塞体肺侧支,栓塞后行选择性体肺侧支造影,观察封堵器的位置、形态及封堵效果。结果 7例介入栓塞患儿,年龄5~71个月,体质量4.2~22.0 kg。有6例患儿栓塞成功,1例栓塞后出现严重低氧血症放弃介入治疗,择期行外科体肺侧支结扎术。介入栓塞15支体肺侧支,共用ADOⅡ7枚、COOK公司不可控弹簧圈22枚和波科公司可控微弹簧圈2枚。即刻造影示无残余分流2例,少量残余分流4例,少-中量残余分流1例。6例介入成功患儿立即行外科术,其中5例行肺动脉闭锁根治术,1例行体肺分流术。外科术中回血不多、未见死亡,随访未见溶血及外周血管损伤等并发症发生。结论 ADOⅡ可控性高、输送鞘小、对血管损伤小,应用于幼儿合并较粗大、迂曲体肺侧支的介入治疗是安全可行的。
Objective To investigate the feasibility and effect of amplatzer duct occluder Ⅱ (ADO Ⅱ) embolization in young children with pulmonary collateral. Methods From March 3, 2014 to April 1, 2015, 7 children (6 males and 1 females) were enrolled in the ADO Ⅱ embolization pulmonary collateral vessels. After embolization, they were subjected to selective pulmonary collateral angiography and observation Blocking device location, shape and blocking effect. Results Seven children were involved in embolism, ranging in age from 5 to 71 months with a body weight of 4.2 to 22.0 kg. 6 cases of successful embolization in children, one case of severe hypoxemia after embolization to give up the interventional treatment, elective surgery in the lungs ligation. Interventional embolization of 15 bronchial collaterals, common use ADO Ⅱ 7, COOK uncontrollable coil 22 and Pocco controllable 2 coil. Immediate contrast angiography showed no residual shunt in 2 cases, a small amount of residual shunt in 4 cases, less - the amount of residual shunt in 1 case. 6 cases of successful intervention in children with immediate surgery, of which 5 cases of pulmonary atresia radical mastectomy, 1 case of systemic pulmonary shunt. Surgical blood back to the small, no death, no follow-up hemolysis and peripheral vascular injury and other complications occurred. Conclusions ADO Ⅱ has high controllability, small transfusion sheath, less damage to blood vessels and more cohesion in young children. It is safe and feasible to use interventional therapy of ADO Ⅱ.