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目的:比较国产封堵器与外科手术治疗动脉导管未闭(PDA)的疗效、并发症和手术时间。方法:2002年1月~2006年12月我院应用国产封堵器介入治疗PDA患者79例,同期开胸手术治疗33例,比较两种疗法的主要并发症及远期疗效等。结果:介入治疗组技术成功率99%,并发血红蛋白尿1例,全组远期随访均保持优良生存,未成功的1例择期行开胸手术治疗。开胸手术组全部成功,并发症有:肺不张1例,胸腔积液2例,进行性血胸二次开胸止血1例,手术伤口感染1例,远期随访术后再通1例,肋骨骨髓炎1例,胸痛1例,均再次接受治疗。结论:国产封堵器介入治疗PDA安全可靠,创伤小、并发症少,远期疗效优良,在其适应证范围内可替代开胸手术。
Objective: To compare the efficacy, complications and operation time of domestic occluder and surgical treatment of patent ductus arteriosus (PDA). Methods: From January 2002 to December 2006, 79 cases of PDA were treated with home-made occluder in our hospital. 33 cases were treated by thoracotomy in the same period. The main complications and long-term effects of the two therapies were compared. Results: The technical success rate was 99% in interventional therapy group and 1 in hemoglobinuria group. The long-term follow-up of the whole group maintained excellent survival. One case of unsuccessful thoracotomy was treated successfully. Thoracic surgery group all successful, complications include: 1 case of atelectasis, pleural effusion in 2 cases, 2 cases of hematoma thoracotomy hemostasis, surgical wound infection in 1 case, long-term follow-up and then through a case 1 case of rib osteomyelitis and 1 case of chest pain were treated again. Conclusion: Domestic occluder interventional therapy PDA safe, reliable, less trauma, fewer complications, long-term curative effect, in its indications can replace thoracotomy.