封堵试验对儿童动脉导管未闭并发重症肺动脉高压性质的判定及介入治疗的意义

发布时间：2018-06-24 21:48

本文选题：儿童 + 动脉导管未闭　；参考：《中国实用儿科杂志》2017年02期

【摘要】：目的探讨在动脉导管未闭(PDA)合并重症肺动脉高压(PAH)患儿中,封堵试验对PAH性质的判定及介入治疗的意义。方法 2008年7月至2014年10月南京医科大学附属儿童医院收治5例单纯PDA合并重症PAH患儿,回顾分析其心导管资料、急性肺血管扩张试验前后相关参数,以及封堵试验前后肺动脉收缩压、主动脉收缩压、肺血管阻力指数、主动脉血氧饱和度变化。结果 5例患儿根据心导管检查资料判断,1例PAH性质为动力性PAH,4例PAH性质难以判断;急性肺血管扩张试验判断,4例符合动力性PAH改变,1例不完全符合;封堵试验结果判断,5例均符合动力性PAH改变。5例患儿成功完成介入治疗,术后肺动脉压力进一步下降,远期随访效果良好。结论对于PDA合并重症PAH患儿,封堵试验可对PAH性质作出诊断,如判定为动力性PAH,可同时完成介入治疗,能有效避免心导管检查及急性肺血管扩张试验评价PAH性质的局限性。
[Abstract]:Objective to investigate the clinical significance of occlusion test in children with patent ductus arteriosus (PDA) complicated with severe pulmonary hypertension (PAH). Methods from July 2008 to October 2014, 5 children with severe PAH were treated in Nanjing Medical University affiliated Children's Hospital. The data of cardiac catheterization and the parameters before and after acute pulmonary vasodilation test were analyzed retrospectively. The changes of pulmonary artery systolic pressure, aortic systolic pressure, pulmonary vascular resistance index and aortic oxygen saturation before and after occlusion were also discussed. Results according to the data of cardiac catheterization, 1 case of PAH was found to be dynamic PAH, 4 cases of PAH were difficult to judge, 4 cases of acute pulmonary vasodilation were found to be in accordance with the change of dynamic PAH in 1 case. The results of occlusion test showed that 5 cases were in accordance with dynamic PAH changes. 5 cases successfully completed interventional therapy. The pulmonary artery pressure decreased further after operation and the long-term follow-up effect was good. Conclusion for the children with PDA complicated with severe PAH, the blocking test can diagnose the nature of PAH. If the PAH is determined as dynamic PAH, it can complete the interventional therapy at the same time, and can effectively avoid the limitation of cardiac catheterization and acute pulmonary vasodilation test to evaluate the nature of PAH.
【作者单位】：南京医科大学附属儿童医院心血管内科;南京医科大学附属儿童医院超声科;
【基金】：江苏省人社厅“六大人才高峰”资助项目(WSN-193)
【分类号】：R725.4

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