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|本期目录/Table of Contents|

国产封堵器与外科手术治疗动脉导管未闭的比较

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第3期
页码:
425-427
栏目:
临床研究
出版日期:
2010-04-06

文章信息/Info

Title:
Comparative study of Chinese-made occluders and surgical procedures in closure of patent ductus arteriosus
作者:
李斌1; 张建华1; 高华2; 苟云久1; 杨永珠1; 高秉仁1
兰州大学第二医院：1.胸心外科，2.麻醉手术科，甘肃 兰州 730030
Author(s):
LI Bin1;  ZHANG Jian-hua1;  GAO Hua2;  GOU Yun-jiu1;  YANG Yong-zhu1;  GAO Bing-ren1
1.Department of Thoracic and Cardiovascular Surgery, 2.Department of Anesthesia and Operation, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China
关键词:
动脉导管未闭; 介入治疗; 心脏外科手术; 对比研究; 远期疗效
Keywords:
patent ductus arteriosus;  transcatheter closure;  cardiac surgical procedure;  comparative study
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
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。
Abstract:
AIM: To compare the clinical effectiveness of Chinese-made occluders and surgical procedures in closure of patent ductus arteriosus (PDA). METHODS: Major complications and long-term clinical results of PDA closure were compared among 79 patients treated with Chinese-made occluders and 33 patients treated surgically. RESULTS: In the group treated with Chinese-made occluders, the technical success rate was 99%. Hemoglobinuria occurred in one case (1%). The one unsuccessful case underwent surgical closure. All patients in the surgical group were successfully treated. Pulmonary atelectasis occurred in one case, hydrothorax in two cases, progressive hemothorax in one case and incision infection in one case. The major complication rate was 15%. Long-term follow-up demonstrated postoperative recanalization in one case, rib osteomylitis in one case, and chest pain in one case. CONCLUSION: Chinese-made occludes are safe and reliable in transcatheter closure of PDA, with fewer complications and better long-term results than surgical procedures.

参考文献/References

［1］ Porstmann W, Wiemy L, Warneke H. Closure of persistent ductus arteriosus without thoracotomy［J］. Get Med Mon, 1967, 12(6):259-261.

［2］Masura J, Walsh KP, Thanopoulous B, et al. Catheter closure of moderate-to large-sized patent ductus arteriosus using the new Amplatzer duct occluder: immediate and short-term results［J］. J Am Coll Cardiol, 1998, 31(4):878-882.

［3］Pass RH, Hijazi Z, Hsu DT, et al. Multicenter USA Amplatzer patent ductus arteriosus occlusion device trial: initial and one-year results［J］.J Am Coll Cardiol, 2004, 44(3):513-519.

［4］张庆桥，蒋世良，黄连军，等. Amplatzer封堵器和外科手术治疗动脉导管未闭的对比研究［J］. 中华心血管病杂志, 2002, 30(7):387-389.

［5］Masura J, Tittel P, Gavora P, et al. Long-term outcome of transcatheter patent ductus arteriosus closure using Amplatzer duct occluders［J］. Am Heart J, 2006, 151(3):755.e7-755.e10.

[6]Mavroudis C, Backer CL, Gevitz M. Forty-six years of patent ductus arteriosus division at Childrens Memorial Hospital of Chicago. Standards for comparison［J］. Ann Surg, 1994, 220(3):402-409.

[7]孙立忠，郭加强，沈宗林，等. 体外循环下动脉导管闭合术179例分析［J］. 中国循环杂志, 1992, 7(3):159-161.

[8] Bilkis AA, Alwi M, Hasri S, et al. The Amplatzer duct occluder: experience in 209 patients［J］. J Am Coll Cardiol, 2001, 37(1):258-261.

[9]Butera G, De Rosa G, Chessa M, et al. Transcatheter closure of persistent ductus arteriosus with the Amplatzer duct occluder in very young symptomatic children［J］. Heart, 2004, 90(12):1467-1470.

备注/Memo

备注/Memo:
收稿日期：2009-06-09.作者简介：李斌，主治医师，硕士Email:leebin9@yahoo.com.cn
更新日期/Last Update: 2010-04-09