Bedside PDA ligation in premature infants less than 28 weeks and 1000 grams.
Bedside PDA ligation in premature infants less than 28 weeks and 1000 grams.
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DOI：
10.1186/s13019-016-0539-3
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发表时间：
2016-10-04
影响因子：
1.6
通讯作者：
Zeybek C
中科院分区：
文献类型：
--
作者：
Avsar MK;Demir T;Celiksular C;Zeybek C
动脉导管未闭（Patent ductus arteriosus，PDA）是一种常见的临床疾病，由于肺血流量增加和从体循环中偷血，引起脑室内出血、肺出血和坏死性小肠结肠炎等血流动力学和呼吸系统问题。妊娠28周前出生的婴儿中PDA的发生率高达70%;极低出生体重早产儿（VLBWPN）的自发闭合率约为34%。用于PDA闭合的前列腺素合成抑制剂药物的起效时间、持续时间和连续疗程的重复次数仍然是有争议的问题。床旁PDA闭合术对成熟和早产儿都是一种安全的外科手术。在这里，我们的目的是回顾性地介绍我们的26例小于28周，1000克，行床旁PDA结扎。这项回顾性研究纳入了2012年至2015年期间接受床旁结扎的26例VLBWPN伴PDA患者。婴儿出生在妊娠第28周（23-27周）之前，体重小于1000克（489-970克）。在这26人中，15人为女性，11人为男性。所有病例均给予吲哚美辛作为药物封闭剂。6例病例因不良反应而停药。所有患者术前均接受了药物治疗。在我们的研究期间没有发生手术死亡。1例气胸被记录为晚期手术并发症。26例患者中有5例失访，最常见的死亡原因是败血症（3例）。其余21例病例于第86-238天出院。术后随访2个月~ 3年。出院后最常见的问题是慢性肺部问题。ICU床旁PDA结扎术是治疗VLBWPN伴临床显著PDA的安全方法。
PDA(Patent ductus arteriosus) is a common and clinically important condition which is presented with a number of hemodynamic and respiratory problems such as intraventricular hemorrhage, pulmonary hemorrhage and necrotizing enterocolitis due to increased pulmonary blood flow and stealing from systemic circulation. The incidence of PDA among the infants that were born before the 28th gestational week is as high as 70 %; and spontaneous closure rates in very-low-birth-weight premature neonates(VLBWPN) is around 34 %. The onset, duration, and repeat number of consecutive courses of the prostaglandin synthesis inhibitor medication for PDA closure are still issues of debate. Bed-side PDA closure is a safe surgical procedure in both mature and premature babies. Here we aim to retrospectively present our 26 cases which were less than 28 weeks and 1000 grams that underwent bed-side PDA ligation. This retrospective study included 26 VLBWPN with PDA that underwent bed-side ligation between 2012 and 2015. Babies were born before the 28th gestational week (23–27 weeks) and less than 1000 grams (489–970 gr). Of the 26, 15 were female and 11 were male. Indomethacin was administered to all of the cases as the medical closing agent. The medication was stopped due to unwanted effects in 6 cases. All of the patients took medical treatment before surgery. No surgical mortality occurred during our study. One case of pneumothorax was recorded as late surgical complication. Five of the 26 patients were lost, and the most common cause of mortality was sepsis (in 3 cases). The remaining 21 cases were discharged on days 86–238. The follow-up periods of the patients were 2 moths - 3 years. The most frequent problems encountered after discharge was chronic lung problems. Bed side PDA ligation surgery in the ICU is a safe method for VLBWPN with clinically significant PDA.
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影响因子：
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Raval, Mehul V.;Laughon, Matthew M.;Phillips, J. Duncan
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