中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2014年
23期
1793-1795
,共3页
儿童%动脉导管未闭%经导管介入%外科经胸封堵%小切口
兒童%動脈導管未閉%經導管介入%外科經胸封堵%小切口
인동%동맥도관미폐%경도관개입%외과경흉봉도%소절구
Child%Patent ductus arteriosus%Transcatheter closure%Transthoracic occlusion%Mini-incision
目的 探讨经导管介入与经胸小切口封堵治疗小儿动脉导管未闭(PDA),对比2种方法的有效性及安全性.方法 选择临沂市人民医院小儿内科2009年1月至2013年11月经导管介入治疗的PDA患儿175例(导管介入组),年龄3个月～14岁,使用介入器材除弹簧圈外,均为国产封堵器.与同期临沂市人民医院心外科经胸小切口封堵治疗患儿157例(小切口组,年龄5个月～ 14岁,使用的封堵器与导管介入组相同)比较,分析其疗效及并发症,并行统计学处理.结果 导管介入组175例患儿中,介入成功171例,技术总成功率为97.71％,无死亡病例,出现并发症8例,并发症发生率为4.57％;经胸小切口组157例患儿中,封堵成功137例,技术总成功率87.26％,死亡1例,出现并发症21例,并发症发生率为13.38％.导管介入组的成功率明显高于小切口组(x2=8.05,P＜0.01);导管介入组的并发症发生率明显低于小切口组(x2=13.48,P＜0.01);且导管介入组的术中失血量、手术时间、住院时间和住院费用均明显低于小切口组[(0.021 ±0.007)L比(0.088 ±0.027)L、(36.81±7.19) min比(88.65±27.92) min、(4.16 ±0.45)d比(10.68±2.38)d、(27 943.6±2 754.1)元比(35 037.4±8 659.2)元],2组各项指标比较差异均有统计学意义(t=29.23、22.19、33.44、18.47,P均＜0.01).结论 经导管介入治疗PDA并发症少,疗效高,明显优于经胸小切口封堵术,是小儿PDA首选的治疗方法.
目的 探討經導管介入與經胸小切口封堵治療小兒動脈導管未閉(PDA),對比2種方法的有效性及安全性.方法 選擇臨沂市人民醫院小兒內科2009年1月至2013年11月經導管介入治療的PDA患兒175例(導管介入組),年齡3箇月～14歲,使用介入器材除彈簧圈外,均為國產封堵器.與同期臨沂市人民醫院心外科經胸小切口封堵治療患兒157例(小切口組,年齡5箇月～ 14歲,使用的封堵器與導管介入組相同)比較,分析其療效及併髮癥,併行統計學處理.結果 導管介入組175例患兒中,介入成功171例,技術總成功率為97.71％,無死亡病例,齣現併髮癥8例,併髮癥髮生率為4.57％;經胸小切口組157例患兒中,封堵成功137例,技術總成功率87.26％,死亡1例,齣現併髮癥21例,併髮癥髮生率為13.38％.導管介入組的成功率明顯高于小切口組(x2=8.05,P＜0.01);導管介入組的併髮癥髮生率明顯低于小切口組(x2=13.48,P＜0.01);且導管介入組的術中失血量、手術時間、住院時間和住院費用均明顯低于小切口組[(0.021 ±0.007)L比(0.088 ±0.027)L、(36.81±7.19) min比(88.65±27.92) min、(4.16 ±0.45)d比(10.68±2.38)d、(27 943.6±2 754.1)元比(35 037.4±8 659.2)元],2組各項指標比較差異均有統計學意義(t=29.23、22.19、33.44、18.47,P均＜0.01).結論 經導管介入治療PDA併髮癥少,療效高,明顯優于經胸小切口封堵術,是小兒PDA首選的治療方法.
목적 탐토경도관개입여경흉소절구봉도치료소인동맥도관미폐(PDA),대비2충방법적유효성급안전성.방법 선택림기시인민의원소인내과2009년1월지2013년11월경도관개입치료적PDA환인175례(도관개입조),년령3개월～14세,사용개입기재제탄황권외,균위국산봉도기.여동기림기시인민의원심외과경흉소절구봉도치료환인157례(소절구조,년령5개월～ 14세,사용적봉도기여도관개입조상동)비교,분석기료효급병발증,병행통계학처리.결과 도관개입조175례환인중,개입성공171례,기술총성공솔위97.71％,무사망병례,출현병발증8례,병발증발생솔위4.57％;경흉소절구조157례환인중,봉도성공137례,기술총성공솔87.26％,사망1례,출현병발증21례,병발증발생솔위13.38％.도관개입조적성공솔명현고우소절구조(x2=8.05,P＜0.01);도관개입조적병발증발생솔명현저우소절구조(x2=13.48,P＜0.01);차도관개입조적술중실혈량、수술시간、주원시간화주원비용균명현저우소절구조[(0.021 ±0.007)L비(0.088 ±0.027)L、(36.81±7.19) min비(88.65±27.92) min、(4.16 ±0.45)d비(10.68±2.38)d、(27 943.6±2 754.1)원비(35 037.4±8 659.2)원],2조각항지표비교차이균유통계학의의(t=29.23、22.19、33.44、18.47,P균＜0.01).결론 경도관개입치료PDA병발증소,료효고,명현우우경흉소절구봉도술,시소인PDA수선적치료방법.
Objective To evaluate efficacy and safety of transcatheter patent ductus arteriosus(PDA) closure compared with mini-incision transthoracic occlusion in children.Methods The safety and complications of 175 patients who underwent transcatheter closure(transcatheter group) hospitalized in Department of Pediatrics,Linyi People's Hospital were analyzed,the ages ranging from 3 months to 14 years,and the material used was Chinese homemade occluder except for the spring coil.Compared with the 157 patients who underwent mini-incision transthoracic occlusion (mini-incision group) hospitalized in Department of Heart Surgery,Linyi People's Hospital from Jan.2009 to Nov.2013,the ages ranging from 5 months to 14 years,the material used was same as the transcatheter group.Acquired data was processed through statistics.Results One hundred and seventy-one of the 175 patients achieved success in the transcatheter group,technically success rate was 97.71％,there were 8 patients with complications,but no death,the occurrence rate of complications was 4.57％ ;however,137 of 157 patients achieved success in the mini-incision group,technically success rate was 87.26％,there were 21 patients with complications and 1 death,the occurrence rate of complications was 13.38％.Success rate of the transcatheter group was much higher than the mini-incision group(x2 =8.05,P ＜ 0.01),while complications of the transcatheter group was significantly less than the mini-incision group(x2 =13.48,P ＜ 0.01),and also the transcatheter group had less hemorrhage during operation,shorter operation time,shorter hospital stay and less hospital expenses compared with the mini-incision group [(0.021 ± 0.007) L vs (0.088 ± 0.027) L,(36.81± 7.19) minvs (88.65 ±27.92) min,(4.16±0.45) dvs (10.68 ±2.38) d,(27 943.6± 2754.1) RMBvs(35037.4±8659.2) RMB;t=29.23,22.19,33.44,18.47,allP＜0.01].Conclusions Transcatheter PDA closure in children is better than mini-incision transthoracic occlusion because of its higher efficacy and lower risk,so it is the first choice of treatment to the children with PDA.
