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经皮封堵卵圆孔未闭治疗偏头痛患儿的临床疗效

Clinical efficacy of percutaneous closure of patent foramen ovale in children diagnosed with migraine.

作者信息

Wang Yakun, Liu Xingmiao, Cheng Ji, Li Dong

机构信息

Pediatric Cardiovascular Center, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin, China.

Department of Pediatric Neurology, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin, China.

出版信息

Front Cardiovasc Med. 2025 Jun 3;12:1611338. doi: 10.3389/fcvm.2025.1611338. eCollection 2025.

Abstract

OBJECTIVE

This retrospective analysis aimed to assess the clinical efficacy of patent foramen ovale (PFO) closure for the treatment of migraine in children.

METHODS

Data from 35 children diagnosed with migraine and PFO (pre-intervention transthoracic echocardiography did not detect PFO in some, but saline contrast echocardiography was positive, indicating hidden PFO), admitted to Tianjin Children's Hospital for PFO closure between March 2020 and February 2024, were retrospectively collected and analysed. The efficacy of post-intervention pain relief was evaluated using an 11-point numerical rating scale (NRS-11), headache impact test-6 (HIT-6), and Paediatric Migraine Disability Assessment Score (PedMIDAS), migraine frequency, and duration of each migraine attack.

RESULTS

At the 1-month follow-up after PFO closure, 20 patients (57.1%) achieved complete relief, and 29 (82.9%) had a reduction in migraine attack frequency by >50%. At the 12-month follow-up, 28 patients (80%) achieved complete relief, and 32 (91.4%) had a reduction in migraine attack frequency by >50%. There were no statistically significant differences between the aura and the non-aura groups. All patients exhibited statistically significant improvement ( < 0.05) in NRS-11, HIT-6, and PedMIDAS, migraine frequency, and duration of each migraine attack. The children in the aura group had a more significant decrease in NRS-11 than those in the non-aura group at 12-month after the operation ( < 0.05). Additionally, there were no statistically significant differences between the two groups in HIT-6, PedMIDAS, and duration of migraine attacks.

CONCLUSION

Percutaneous PFO closure demonstrated significant clinical efficacy and safety in the treatment of migraine in children.

摘要

目的

本回顾性分析旨在评估卵圆孔未闭(PFO)封堵术治疗儿童偏头痛的临床疗效。

方法

回顾性收集并分析2020年3月至2024年2月期间在天津市儿童医院因PFO封堵术入院的35例诊断为偏头痛且合并PFO的儿童的数据(部分患儿术前经胸超声心动图未检测到PFO,但盐水对比超声心动图呈阳性,提示隐匿性PFO)。采用11点数字评定量表(NRS - 11)、头痛影响测试 - 6(HIT - 6)、儿童偏头痛残疾评估量表(PedMIDAS)、偏头痛发作频率及每次偏头痛发作持续时间评估干预后疼痛缓解的疗效。

结果

PFO封堵术后1个月随访时,20例患者(57.1%)实现完全缓解,29例(82.9%)偏头痛发作频率降低>50%。术后12个月随访时,28例患者(80%)实现完全缓解,32例(91.4%)偏头痛发作频率降低>50%。有先兆组与无先兆组之间无统计学显著差异。所有患者在NRS - 11、HIT - 6、PedMIDAS、偏头痛发作频率及每次偏头痛发作持续时间方面均表现出统计学显著改善(P < 0.05)。术后12个月时,有先兆组患儿NRS - 11评分较无先兆组下降更显著(P < 0.05)。此外,两组在HIT - 6、PedMIDAS及偏头痛发作持续时间方面无统计学显著差异。

结论

经皮PFO封堵术在治疗儿童偏头痛方面显示出显著的临床疗效和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d43b/12170634/5b722cc4acb2/fcvm-12-1611338-g001.jpg

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