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頁籤選單縮合
題名 | Transcatheter Closure of Patent Ductus Arteriosus with Coils=經心導管以螺絲圈關閉存開性動脈導管 |
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作者 | 黃碧桃; 陸振翮; 李必昌; 傅雲慶; 邢學平; 林長興; 邢榮華; 孟春昌; | 書刊名 | Acta Cardiologica Sinica |
卷期 | 13:4 民86.10-12 |
頁次 | 頁169-177 |
分類號 | 417.5214 |
關鍵詞 | 介入性心導管術; 先天性心臟病; 螺絲圈; Catheterization; Coil; Patent ductus arteriosus; Pulmonary embolism; |
語文 | 英文(English) |
中文摘要 | 本題:本研究為評估在兒童期,經心導管以螺絲圈關閉存性動脈導管的中短期療效。 背景:經心導管以螺絲圈關閉存開性動脈導管,在國外已有初步成效,我們報告在國內治療39例病童的成功經驗。 材料及方法:共有39例病童患先天性心臟病--存開性動脈導管,接受經心導管以螺絲圈關閉動脈導管。病童中間年齡為4.3歲,中間體重為17公斤,動脈導管的最小直徑為0.5∼4.5毫米,平均值為1.84毫米。經心導管檢查,以Fick氏原理計算得肺循環血流量與體循環血流比為1.01∼3.31,平均值為1.41±0.45。依據動脈導管直徑大小不同,每位病童被置入1∼3個螺絲圈,動脈導管直徑愈大置入的螺絲圈愈多。在研究初期,共有七位病童發生13次螺絲圈暫時性栓塞於左或右肺動脈中。所有栓塞的螺絲圈均經陷井導管取出,並無其他合併症。手術後,39例病童的動脈導管的雜音均消失,以杜下勒及彩色杜卜勒超音波心圖追蹤,1天、2天、7天、1個月、3個月、6個月及1年的動脈導管完全關閉率分別為71.8%、74.4%、79.5%、92.3%、92.3%、92.3%、91.4%、及94.7%。 討論:在兒童期,經導管以螺絲圈治療存開性動脈導管是種很安全而且有效的方法,中短期的追蹤結果良好。 |
英文摘要 | Objectives. This study was performed to assess the efficacy and short to medium-term results in children of transcatheter closure of the patent ductus arteriosus with coils. Background. Transcatheter closure of the patent ductus arteriosus using coils has been reported in the English literature with encouraging result. Experience here and the short to medium-term results in Chinese children of transcatheter closure of the patent ductus arteriosus is reported. Materials and Methods. Thirty-nine patients underwent transcatheter closure of patent ductus arteriosus with coils. Median age was 4.3 years and median body weight was 17.3 Kg. The ductal diameters ranged from 0.5 mm to 4.5 mm with mean of 1.84 mm. The calculated pulmonary to systemic flow (Qp/Qs) ratio by Fick's principle was 1.01 to 3.31, with mean ± SD = 1.41 ± 0.45. Results. One to three coils weere inserted in every patient, depending on the ductal diameter. A larger ductal diameter implies a need for more coils. All patients with a ductal diameter exceeding 2.6 mm required two or more coils. Thirteen coils had embolized to the left or right pulmonary arteries in seven patients. All of the pulmonary embolized coils were retrieved with a snare catheter. Two patients were given up and eventually sent for surgical ligation because of repeated coil embolization in the pulmonary arteries. The other 11 cases had successful coils subsequently placed to close the ductus arteriosus. The ductal murmur disappeared immediately after catheterization in all 39 children. A follow-up study with Doppler technique and color Doppler flow mapping revealed that complete closure was achieved in 71.8%, 74.4%, 79.5%, 92.3%,92.3%,91.4% and 94.7% at 24 hours, 48 hours, 7 days, 1 month, 3 months, 6 months and 1 year, respectively. There were no other complications. Conclusion. Transcatheter closure of the patent ductus arteriosus with coils is an extremely safe and effective method for use in children. Both short and medium-term results are excellent. |
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