文章摘要
顾正南,杨 荣,盛燕辉,孔祥清,张 浩,许 迪,雍永宏,周 蕾,曹克将.动脉导管未闭伴重度肺动脉高压患者的介入治疗[J].南京医科大学学报,2011,(5):727~729
动脉导管未闭伴重度肺动脉高压患者的介入治疗
Transcatheter closure of patent ductus arteriosus with severe pulmonary arterial hypertension
投稿时间:2010-11-02  
DOI:10.7655
中文关键词: 动脉导管未闭  重度肺动脉高压  介入封堵
英文关键词: patent ductus arteriosus  severe pulmonary arterial pressure  transcatheter closure
基金项目:国家“十一五”课题(2007BAI05B03);南京市科技发展项目(200901077)
作者单位
顾正南 南京医科大学第一附属医院心脏科,江苏 南京 210029 
杨 荣 南京医科大学第一附属医院心脏科,江苏 南京 210029 
盛燕辉 南京医科大学第一附属医院心脏科,江苏 南京 210029 
孔祥清 南京医科大学第一附属医院心脏科,江苏 南京 210029 
张 浩 南京医科大学第一附属医院心脏科,江苏 南京 210029 
许 迪 南京医科大学第一附属医院心脏科,江苏 南京 210029 
雍永宏 南京医科大学第一附属医院心脏科,江苏 南京 210029 
周 蕾 南京医科大学第一附属医院心脏科,江苏 南京 210029 
曹克将 南京医科大学第一附属医院心脏科,江苏 南京 210029 
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中文摘要:
      目的:探讨介入封堵治疗伴重度肺动脉高压(severe pulmonary arterial hypertension ,SPH)的动脉导管未闭(patent ductus arteriosus ,PDA)患者的可行性,并评价其中远期疗效?方法:采用介入试验性封堵方法对伴有SPH的37例PDA患者进行介入封堵治疗,并进行中长期随访?结果:27例PDA患者接受了介入封堵治疗?封堵后与封堵前相比较,患者的股动脉血氧饱和度明显升高[(96.2±1.4)% vs (94.3±1.9)%,P < 0.05],肺动脉收缩压明显下降[(45.1±10.9)mmHg vs (90.1±17.2)mmHg,P < 0.05],主动脉压升高[(129.3±24.8)mmHg vs (120.1±20.5)mmHg,P < 0.05]?10例未行介入治疗的患者,术前6分钟步行试验后动脉血氧饱和度明显下降(均低于90%),试封堵时肺动脉压无明显下降,甚至升高?平均随访(42.2±23.9)个月?27例PDA封堵患者在术后肺动脉收缩压持续下降,基本恢复到正常水平(29.3±3.6)mmHg?结论:应用试验性封堵方法介入治疗伴SPH的PDA患者可以获得较好的中长期预后?
英文摘要:
      Objective:To investigate the application of transcatheter closure in patients with patent ductus arteriosus(PDA) with severe pulmonary arterial hypertension(SPH), and assess the medium and long-term results. Methods:Thirty seven patients with PDA underwent attempted transcatheter closure. On the basis of haemodynamic and clinical data obtained before and after attempted occlusion, the final PDA was carried out. The follow-up time was 1 week, 1,3, 6,12 months and every year after transcatheter closure. Results:The occlusion therapy was performed in 27 PDA. Systemic artery oxygen saturation before and after closure was (94.3±1.9)% and (96.2±1.4)%, respectively(P < 0.05). Systolic pulmonary arterial pressure (SPAP) decreased significantly from(90.1±17.2)mmHg to (45.1±10.9)mmHg (P < 0.05) and systolic arterial pressure increased significantly from (120.1±20.5)mmHg to (129.3±24.8)mmHg after closure(P < 0.05). The interventional occlusion was not carried out in 10 patients because of significant reduction of systemic artery oxygen saturation after six-minute walk test and no significant reduction of SPAP during the trial closure of PDA. In 27 patients with closure of PDA, SPAP was reduced to normal level in follow-up. Conclusion:Transcatheter closure is an effective treatment for patients with PDA associated with reversible SPH during the medium and long-term follow-up.
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