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目的:评价西宁地区应用封堵器治疗动脉导管未闭伴重度肺动脉高压患者术后的中远期疗效。方法:随访观察46例应用国产封堵器封堵的伴SPH的PDA患者封堵前后的肺动脉压力,于术后24h、48h、1个月、6个月、12个月分别予以随访,以后每l2个月随访1次。内容包括症状、体征、X线胸片及超声心动图。结果:46例封堵后(30～60)min肺动脉压均明显下降,术后降主动脉造影示无残余分流41例,微量残余分流4例,少量残余分流1例。24h彩色多普勒检查示无残余分流43例,微量残余分流3例,48h该分流消失。随访观察(6～48)个月(平均18个月),所有患者临床症状缓解,活动耐量增加。X线胸片示肺血明显减少,肺动脉段凸出程度减轻,46例心胸比例有不同程度缩小。彩色多普勒检查示所有病例无PDA再通,无装置移位、脱落及肺动脉狭窄,无新发生心律失常等。结论:应用封堵器治疗一些PDA伴SPH的患者中远期疗效确切,安全性好。
OBJECTIVE: To evaluate the long-term and long-term effect of occluder device in patients with patent ductus arteriosus and severe pulmonary hypertension in Xining area. Methods: Forty-six patients with PDA with SPH occluded in our hospital were followed up for observation of pulmonary artery pressure before and after occlusion, and were followed up at 24h, 48h, 1 month, 6 months and 12 months respectively. l2 months followed up 1 time. Including the symptoms, signs, chest X-ray and echocardiography. Results: The pulmonary arterial pressure was significantly decreased in 46 cases (30 ~ 60) min after the occlusion. There were 41 cases with residual shunt in the descending aorta, 4 cases with minimal residual shunt, and 1 case with small residual shunt. 24h color Doppler examination showed no residual shunt in 43 cases, trace residual shunt in 3 cases, 48h the shunt disappeared. Follow-up observation (6 ~ 48) months (average 18 months), all patients with clinical symptoms, activity tolerance increased. X-ray showed significantly decreased pulmonary blood flow, pulmonary artery segment protrusion to reduce the extent of 46 cases of chest and chest to varying degrees reduced. Color Doppler examination showed no PDA recanalization in all cases, no device displacement, loss and pulmonary stenosis, no new arrhythmia. CONCLUSIONS: The use of occluder in the treatment of some patients with PDA with SPH has long-term curative effect and good safety.