论文部分内容阅读
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(patentductus 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。
Objective: To investigate the feasibility of interventional occlusion in the treatment of patent ductus arteriosus (PDA) patients with severe pulmonary arterial hypertension (SPH) and to evaluate the long-term efficacy. Methods: Thirty-seven PDA patients with SPH were treated by interventional blocking method and followed up for a long term. Results: Twenty-seven PDA patients underwent interventional occlusion. After occlusion, the femoral artery oxygen saturation was significantly increased in the femoral artery after closure ([96.2 ± 1.4] vs (94.3 ± 1.9)%, P <0.05] and pulmonary artery systolic pressure significantly decreased (45.1 ± 10.9) mmHg vs (90.1 ± 17.2) mmHg, P <0.05], and aortic pressure elevation (129.3 ± 24.8 mmHg vs (120.1 ± 20.5) mmHg, P <0.05). In 10 patients who did not undergo interventional therapy, arterial oxygen saturation decreased significantly (all below 90%) 6 minutes before the test, and no significant decrease or even increase of pulmonary arterial pressure was observed when the test was stopped. The average follow-up (42.2 ± 23.9) months. In 27 cases of PDA occlusion, the pulmonary systolic pressure continued to decrease after operation, and returned to the normal level (29.3 ± 3.6) mmHg. CONCLUSIONS: The use of experimental closure in the treatment of PDA patients with SPH can achieve better long-term prognosis.