动脉导管造影联合经胸超声在动脉导管未闭封堵术治疗中的应用

A modified management of the transcatheter occlusion of patent ductus arteriosus: using angiography combined with transthoracic echocardiography

摘要:

目的：探讨经动脉导管造影联合经胸超声能否作为动脉导管未闭封堵术的一种简化治疗方法。方法：选择欲行动脉导管未闭介入封堵术患儿40例，随机分为观察组20例和对照组20例。对照组应用传统的动脉导管未闭介入封堵技术。观察组采用简化的动脉导管未闭介入封堵术，并借助经胸超声实时监测。结果：观察组20例患儿用简化方法行动脉导管未闭封堵术均一次封堵成功，超声显示封堵器位置良好，左、右肺动脉、降主动脉血流速度均在正常范围内。观察组患儿放射线曝露时间明显少于对照组；观察组患儿无一例与血管穿刺相关的血管并发症发生，但对照组患儿发生4例血管并发症。患儿的恢复时间和滞留于监护室的时间也相应缩短；观察组总的医疗费用少于对照组。结论：经动脉导管造影联合经胸超声行PDA封堵术是一种良好的简化封堵方法。［中国当代儿科杂志，2010，12（2）：103-105］

Abstract:

OBJECTIVE: To evaluate the feasibility of angiography combined with transthoracic echocardiography (TEE) as a modified management of the transcatheter occlusion of patent ductus arteriosus (PDA). METHODS: Forty children with PDA were randomly divided into two groups (n=20 each): observed and control. The control group accepted traditional transcatheter occlusion, and the observed group received a modified management (angiography combined with TEE). The children in the observed group were monitored by realtime TTE. RESULTS: A complete occlusion was acquired by one occlusion operation in each child in the observed group. The TTE demonstrated that the occlusion device was in place, and that the blood flow velocities in the left and right pulmonary artery and the descending aorta were in normal ranges. There were shorter X-ray exposure time, shorter recovering time and less ICU stay time in the observed group than in the control group. The complications associated with blood vessel puncturation occurred in four children from the control group, but none of the observed group had the complications. The total hospitalization cost in the observed group was less than in the control group. CONCLUSIONS: Angiography combined with TEE as a modified management of the transcatheter occlusion of PDA is recommended.［Chin J Contemp Pediatr, 2010, 12 (2):103-105］