中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2009年
11期
998-1001
,共4页
朱鲜阳%陈火元%张端珍%韩秀敏%盛晓棠%崔春生%张坡%王琦光
硃鮮暘%陳火元%張耑珍%韓秀敏%盛曉棠%崔春生%張坡%王琦光
주선양%진화원%장단진%한수민%성효당%최춘생%장파%왕기광
动脉导管未闭%心脏导管插入术%中年人%老年人
動脈導管未閉%心髒導管插入術%中年人%老年人
동맥도관미폐%심장도관삽입술%중년인%노년인
Ductus arteriosus%patent%Heart catheterization%Middle aged%Aged
目的 分析中老年动脉导管未闭(PDA)患者的临床特征及探讨行经导管封堵治疗的安全性.方法 选择2000年1月至2009年4月在我科介入治疗的139例40岁以上PDA患者,男22例,女117例,年龄40～74(49.8±6.8)岁,术前心功能分级为Ⅰ级64例,Ⅱ级53例,Ⅲ级16例,Ⅳ级6例,分析中老年PDA患者临床特征及观察封堵PDA前后肺动脉压和心功能的改善情况.结果 139例患者中合并肺动脉高压107例,发生率为77.0%,3例严重肺动脉高压者不适宜手术治疗,其余136例均成功行介入治疗,成功率为97.8%.封堵PDA后主动脉造影显示残余分流微量14例,少量2例,中等量分流1例,无手术相关并发症.术后心功能显著改善,肺动脉收缩压由术前(47.3±23.9)mm Hg(1 mm Hg=0.133 kPa)降至(28.1±12.3)mm Hg,肺动脉平均压由(31.7±17.4)mm Hg降至(17.9±8.8)mm Hg(均P<0.01).结论 中老年PDA患者肺动脉高压发生率高,心功能差,经导管封堵中老年PDA是一种安全有效的方法 .
目的 分析中老年動脈導管未閉(PDA)患者的臨床特徵及探討行經導管封堵治療的安全性.方法 選擇2000年1月至2009年4月在我科介入治療的139例40歲以上PDA患者,男22例,女117例,年齡40～74(49.8±6.8)歲,術前心功能分級為Ⅰ級64例,Ⅱ級53例,Ⅲ級16例,Ⅳ級6例,分析中老年PDA患者臨床特徵及觀察封堵PDA前後肺動脈壓和心功能的改善情況.結果 139例患者中閤併肺動脈高壓107例,髮生率為77.0%,3例嚴重肺動脈高壓者不適宜手術治療,其餘136例均成功行介入治療,成功率為97.8%.封堵PDA後主動脈造影顯示殘餘分流微量14例,少量2例,中等量分流1例,無手術相關併髮癥.術後心功能顯著改善,肺動脈收縮壓由術前(47.3±23.9)mm Hg(1 mm Hg=0.133 kPa)降至(28.1±12.3)mm Hg,肺動脈平均壓由(31.7±17.4)mm Hg降至(17.9±8.8)mm Hg(均P<0.01).結論 中老年PDA患者肺動脈高壓髮生率高,心功能差,經導管封堵中老年PDA是一種安全有效的方法 .
목적 분석중노년동맥도관미폐(PDA)환자적림상특정급탐토행경도관봉도치료적안전성.방법 선택2000년1월지2009년4월재아과개입치료적139례40세이상PDA환자,남22례,녀117례,년령40～74(49.8±6.8)세,술전심공능분급위Ⅰ급64례,Ⅱ급53례,Ⅲ급16례,Ⅳ급6례,분석중노년PDA환자림상특정급관찰봉도PDA전후폐동맥압화심공능적개선정황.결과 139례환자중합병폐동맥고압107례,발생솔위77.0%,3례엄중폐동맥고압자불괄의수술치료,기여136례균성공행개입치료,성공솔위97.8%.봉도PDA후주동맥조영현시잔여분류미량14례,소량2례,중등량분류1례,무수술상관병발증.술후심공능현저개선,폐동맥수축압유술전(47.3±23.9)mm Hg(1 mm Hg=0.133 kPa)강지(28.1±12.3)mm Hg,폐동맥평균압유(31.7±17.4)mm Hg강지(17.9±8.8)mm Hg(균P<0.01).결론 중노년PDA환자폐동맥고압발생솔고,심공능차,경도관봉도중노년PDA시일충안전유효적방법 .
Objective To analyze the clinical feature and the effects of transcatheter closure of adult patients with patent ductus arteriosus (PDA). Methods Between January 2000 and April 2009, 139 patients [22 male, aged from 40 to 74:(49.8±6.8) years] with PDA were hospitalized in our hospital. Clinical data and effects of transcatheter closure of PDA were analyzed. Results There were 64 patients with NYHA class Ⅰ, 53 with class Ⅱ, 16 with class Ⅲ and 6 with class Ⅳ before procedure. In 139 patients, pulmonary arterial hypertension (PAH) was found in 107 out of 139 patients (77.0%). Transcatheter PDA closure was not performed in 3 patients due to severe PAH and successfully performed in the remaining 136 patients (97.8%) without major complications. Post procedure aortic angiography evidenced minor residual shunt in 14 cases, small residual shunt in 2 cases and moderate shunt in 1 case. The NYHA class was significantly improved and the PAH significantly reduced [sPAP: (47.3±23.9)mm Hg(1 mmHg=0.133 kPa) vs. (28.1±12.3) mm Hg,P<0.01] post procedure. Conclusion PAH and heart failure were commonly associated with PDA in adult patients. Transcatheter PDA closure is safe and effective in these patients except those with severe PAH.
