动脉导管未闭的胸腔镜夹闭术与经导管封堵术的疗效比较：随机临床试验

Outcomes of thoracoscopic clipping versus transcatheter occlusion of patent ductus arteriosus: randomized clinical trial.

作者信息

Liem Nguyen Thanh, Tung Cao Viet, Van Linh Nguyen, Tuan To Manh, Quang Le Hong, Tu Tran Thanh

机构信息

Vinmec International Hospital, Hanoi, Vietnam.

Cardiology Department, National Hospital of Pediatrics, Hanoi, Vietnam, Hanoi, Vietnam.

出版信息

J Pediatr Surg. 2014 Feb;49(2):363-6. doi: 10.1016/j.jpedsurg.2013.09.007.

DOI:10.1016/j.jpedsurg.2013.09.007

PMID:24528987

Abstract

AIM

To compare outcomes of thoracoscopic clipping (TC) versus transcatheter occlusion (TO) for patent ductus arteriosus (PDA).

PATIENTS AND METHODS

One hundred patients were enrolled in the study from May 2010 to December 2011. Those patients were randomized into 2 groups: group one received TC, group two received TO.

RESULT

There were no significant differences concerning width or length of the ductus (P>0.05). However the median age and median weight of patients in the TO group were greater than in the TC group (P<0.05). Mean operative time was 32 ± 12 min in the TC group versus 20 ± 3 min in the TO group (P<0.05). There were no deaths in either group. There were no complications in the TC group whereas three patients in the TO group had complications and required subsequent operation. Median postoperative stay was 3.5 days (IQR: 3.0-4.3) in the TC group versus 3 days (IQR: 2.0-4.0) in the TO group (P<0.05). There was no residual shunting in either group. Average cost for one patient was $645 ± 232 in the TC group versus $1,260 ± 204 in the TO group (P<0.001).

CONCLUSION

Thoracoscopic clipping is safer than transcatheter occlusion for PDA repair, with the same effectiveness and lower cost.

摘要

目的

比较胸腔镜结扎术（TC）与经导管封堵术（TO）治疗动脉导管未闭（PDA）的疗效。

患者与方法

2010年5月至2011年12月，100例患者纳入本研究。这些患者被随机分为两组：一组接受TC治疗，二组接受TO治疗。

结果

动脉导管的宽度和长度方面无显著差异（P>0.05）。然而，TO组患者的年龄中位数和体重中位数大于TC组（P<0.05）。TC组平均手术时间为32±12分钟，而TO组为20±3分钟（P<0.05）。两组均无死亡病例。TC组无并发症，而TO组有3例患者出现并发症并需要后续手术。TC组术后住院时间中位数为3.5天（IQR：3.0 - 4.），TO组为3天（IQR：2.0 - 4.0）（P<0.05）。两组均无残余分流。TC组每位患者的平均费用为645±232美元，TO组为1260±204美元（P<0.001）。