关键词: 动脉导管未闭;Amplatzer封堵器;肺动脉高压

    摘 要:目的 Amplatzer封堵器试验性关闭动脉导管未闭(PDA)，评价其在PDA合并重度肺动脉高压(SPH)患者封堵治疗中的临床价值. 方法 对7(男4，女3)例PDA合并SPH患者实施PDA封堵器堵塞PDA试验，观察肺动脉收缩压、肺动脉平均压有无降低及血氧饱和度变化，以此分析肺血管病变是否可逆. 结果 7例重度肺动脉高压者，肺动脉收缩压11.3～18.7(12.8±4.9)kPa，平均压为6.9～12.3(9.1±2.5)kPa，其中2例血氧饱和度小于90%，6例试封堵术后30min～1h肺动脉收缩压降至6.0～13.1(7.6±3.1)kPa，肺动脉平均压降至2.7～8.3(4.4±2.8)kPa，行永久性封堵治疗.1例肺动脉压和动脉血氧饱和度无明显变化，为阻力性肺动脉高压，不宜进行封堵治疗. 结论 对于PDA伴严重肺动脉高压者，Amplatzer封堵器关闭PDA试验是鉴别肺动脉高压是否为阻力性肺动脉高压的安全有效的方法，在Am-platzer法封堵器治疗PDA合并重度肺动脉高压(SPH)的病例选择中有重要的临床价值.

    Clinical role of experimental transcatheter closure of PDA by Amplatzer occluder device in the closure of PDA with severe pulmonary hypertension

    DAI Zheng-Xue，ZHANG Yu-Shun，JIA Guo-Liang，WANG Shu-Xiang，LI Huan，WU Dong-Liang，WANG Xiao-Yan

    Department of Cardiovasology，Xijing Hospital，Fourth Military Medical University，Xi'an710033，China

    Keywords:ductus arteriosus，patent;Amplatzer closure;pulmonary hypertension

    Abstract:AIM To evaluate the clinical usefulness of experi-mental transcatheter closure of patent ductus arteriosus(PDA)using the Amplatzer duct occluder(ADO)in the clo-sure of PDA with severe pulmonary hypertension(SPH).METHODS Experimental transcatheter closure of PDA us-ing ADO was performed in seven patients suffering from PDA with SPH.The changes of pulmonary hypertension and SaO 2 was monitored30min to1h to distinguish between reversible and irreversible elevations in pulmonary vascular resistance.RESULTS The systolic pulmonary hypertension was de-creased from11.3～18.7(12.8±4.9)kPa(1mmHg=0.133kPa)to6.0～13.1(7.6±3.1)kPa ......