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首页> 外文学位 >Patent ductus arteriosus management in premature neonates weighing 1000-2000 grams: A comparison of prophylactic closure, clinically-indicated closure, and supportive care.
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Patent ductus arteriosus management in premature neonates weighing 1000-2000 grams: A comparison of prophylactic closure, clinically-indicated closure, and supportive care.

机译：重达1000-2000克的早产儿动脉导管未闭的管理：预防性封闭，临床指示性封闭和支持治疗的比较。

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摘要

Problem: The patent ductus arteriosus (PDA) is an opening between the aorta and pulmonary arteries that fails to close after birth. This allows for a shunting of blood between the vessels and is associated with multiple health complications, including chronic lung disease (CLD) and necrotizing enterocolitis (NEC). This literature review was conducted to determine which methods are most advantageous for achieving closure, as well as the necessity of closure in the first place. Methods: Systematic literature review using the PubMed article database at the Weill Cornell Medical Library. Results: There is no clear consensus in the literature on the necessity of medical closure, nor on what treatment is most effective for achieving closure. However, cyclooxygenase (COX) inhibitors are successful at inducing PDA closure in over 67% of neonates and ibuprofen may be the most beneficial COX inhibitor to use. Prophylactic COX inhibitor treatment reduces the likelihood of intraventricular hemorrhage and is preferable to treatment after symptoms develop. Surgical ligation may only be indicated for neonates in whom closure by COX inhibitor treatment is unlikely. Finally, medical closure methods may not impact neonatal outcome or morbidities, and may only be indicated in neonates in whom spontaneous closure is unlikely to occur. Conclusions: There is a need for randomized controlled clinical trials to establish evidence-based protocol for PDA closure, including the necessity of treatment and the most beneficial methods for achieving closure.
机译：问题：动脉导管未闭（PDA）是主动脉和肺动脉之间的开口，出生后无法关闭。这允许血管之间的血液分流，并与多种健康并发症相关，包括慢性肺病（CLD）和坏死性小肠结肠炎（NEC）。进行文献综述以确定哪种方法最有利于实现封闭，以及首先需要封闭的方法。方法：使用Weill Cornell医学图书馆的PubMed文章数据库进行系统的文献综述。结果：关于药物封闭的必要性以及哪种药物最有效实现封闭的文献没有明确共识。但是，环氧合酶（COX）抑制剂可成功诱导超过67％的新生儿PDA闭合，布洛芬可能是最有益的COX抑制剂。预防性COX抑制剂治疗可减少脑室内出血的可能性，并且优于症状发作后的治疗。手术结扎仅适用于不太可能通过COX抑制剂治疗封闭的新生儿。最后，药物封闭方法可能不会影响新生儿的结局或发病率，并且只能在不太可能发生自发封闭的新生儿中使用。结论：需要进行随机对照临床试验以建立基于证据的PDA封闭方案，包括治疗的必要性和实现封闭的最有益方法。

著录项

  • 作者

    Tawil, Yehudis Rivka.;

  • 作者单位

    Weill Medical College of Cornell University.;

  • 授予单位 Weill Medical College of Cornell University.;
  • 学科 Health Sciences Medicine and Surgery.
  • 学位 M.S.H.S.
  • 年度 2012
  • 页码 33 p.
  • 总页数 33
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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