Chen Pengyuan,Zhou Chaoran,Li Gang.Interventional treatment of children with congenital heart disease with a second-generation Cera patent ductus arteriosus occluder[J].Journal of Clinical Pediatric Surgery,2019,18(07):573-578.[doi:10.3969/j.issn.1671-6353.2019.07.011]
第二代Cera动脉导管未闭封堵器介入治疗小儿先天性心脏病的疗效分析
- Title:
- Interventional treatment of children with congenital heart disease with a second-generation Cera patent ductus arteriosus occluder
- Keywords:
- Ductus Arteriosus patent; Heart Desease/CN
- 分类号:
- R725.4;R540.4+6
- 摘要:
- 目的 初步分析第二代Cera动脉导管未闭封堵器介入治疗小儿先天性心脏病的疗效，为更加系统地治疗小儿先天性心脏病提供理论依据。方法 选取四川省医学科学院四川省人民医院儿科2016年11月至2017年11月收治且符合纳入标准的46例先天性心脏病患儿作为研究对象，采用随机分组的方法将患儿分成第一代Cera动脉导管未闭封堵器（ADOⅠ）组和第二代Cera动脉导管未闭封堵器（ADOⅡ）组，所有患儿选用Cera动脉导管未闭封堵器（均符合治疗准则及患儿的解剖特点），每组各23例；并比较围术期两组患儿的气管导管拔除时间、ICU滞留时间，超声心动图监测结果以及出院时、出院后1个月和出院后3个月的红细胞、红细胞压积、血红蛋白指标计数等指标。结果 ADOⅡ组患儿气管导管拔除时间、ICU滞留时间显著低于ADOⅠ组（P<0.05）。两组患儿治疗前后超声心动图监测结果显示，ADOⅡ组出院后1个月和出院后3个月射血分数、左室短轴缩短百分率、每搏输出量均显著高于ADOⅠ组（P<0.05），而舒张末期左心房内径显著低于ADOⅠ组（P<0.05）。两组患儿出院时、出院后1个月和出院后3个月比较，红细胞、红细胞压积、血红蛋白指标计数的差异均有统计学意义（P<0.05）。从治疗结局来看，ADOⅠ组有效率为82.61%、ADOⅡ组有效率为95.65%，差异有统计学意义（P<0.05）。结论 第二代Cera动脉导管未闭封堵器介入治疗小儿先天性心脏病的整体疗效更佳，值得临床推广。
- Abstract:
- Objective To explore the efficacy of second-generation Cera patent ductus arteriosus(PDA) occluder in the interventional treatment of congenital heart disease(CHD) in children and provide a theoretical basis for managing CHD in children.Methods Forty-six hospitalized CHD children from November 2016 to November 2017 were selected and randomly divided into ADOⅠand ADOⅡgroups(n=23 each).Duration of intensive care unit(ICU) stay,imaging of echocardiography and statistic differences of erythrocyte,hematocrit and hemoglobin counts at discharge and 1/3 months post-discharge were compared.Results Tracheal catheter removal time and ICU stay duration were significantly shorter in ADOⅡgroup than those in ADOⅠgroup(P<0.05).As demonstrated by echocardiographic monitoring results before and after treatment,ejection fraction,left ventricular fractional shortening and stroke output were significantly higher at 1/3 months post-discharge in ADOⅡgroup than those in ADOⅠgroup.And end-diastolic left atrium diameter was significantly lower than that of ADOⅠgroup.At discharge and 1/3 months post-discharge,two groups had statistically significant differences in erythrocyte,hematocrit and hemoglobin count(P<0.05).As for treatment outcomes,ADOⅠand Ⅱ groups had an effective rate of 82.61% and 95.65% respectively and the difference was statistically significant(P<0.05).Conclusion The second-generation Cera PDA occluder offers better intervention of CHD children than its first-generation cousin.Wider clinical popularization is warranted.
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备注/Memo
收稿日期:2018-10-27。
基金项目:四川省卫生厅科研项目（编号：17PJ264）
通讯作者:陈芃螈,Email:cpyhigh@qq.com