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目的 :评价 Porstmann法、弹簧栓子法和 Amplatzer封堵器对动脉导管培养闭的治疗效果。方法 :3种方法共治疗动脉导管未闭 (PDA) 5 0例 ,其中 Porstm ann法 6例 ,弹簧栓子法 10例 ,Amplatzer封堵器 34例。所有患者在 PDA封堵后 10 m in重复主动脉造影观察有无残余分流 ;术后 2 4h、1月、6月和 12月行超声心电图检查 ,观察 PDA有无再通及残余分流。结果 :全组 5 0例 ,成功 49例。Porstm ann法有 1例由于鞘管不通过股动脉而失败。术后 10 min主动脉造影术 ,Amplatzer封堵器 4例有微 -少量残余分流。术术 2 4h超声心电图均无残余分流。随访 1～ 12个月 ,均未发现有残余分流和 PDA再通。结论 :经导管治疗 PDA是有效的非手术方法。Porstmann法已较少采用 ;直径 <3 m m的PDA首选弹簧栓子法 ;3～ 10 m m的 PDA采用 Am platzer封堵器治疗 ;直径 >10 m m者则应考虑手术治疗。
PURPOSE: To evaluate the therapeutic effect of Porstmann’s method, spring embolism method and Amplatzer occluder on the ductus arteriosus. Methods: Three methods were used to treat 50 cases of patent ductus arteriosus (PDA), including 6 cases of Porstm ann method, 10 cases of spring embolization method and 34 cases of Amplatzer occluder. All patients underwent repeat aortic angiography 10 days after PDA occlusion to observe the presence or absence of residual shunt; 24 hours after surgery, January, June and December underwent echocardiography to observe the PDA without recurrence and residual shunt. Results: The whole group of 50 patients, 49 cases of success. One of the Porstm ann failed because the sheath did not pass through the femoral artery. Aortography at 10 min after surgery and Amplatzer occluder in 4 patients with micro-small residual shunt. 24 h echocardiography showed no residual shunt. All patients were followed up for 1 ~ 12 months. No residual shunt and PDA recanalization were found. Conclusion: Transcatheter PDA is an effective non-surgical method. Porstmann method has been less used; diameter of <3 m m PDA preferred spring emboli method; 3 ~ 10 m m PDA with Am platzer occluder treatment; diameter> 10 m m should consider surgery.