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首页> 外文期刊>Interactive cardiovascular and thoracic surgery >Management of the persistent ductus arteriosus in infants of very low birth weight: early and long-term results
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Management of the persistent ductus arteriosus in infants of very low birth weight: early and long-term results

机译：出生体重极低的婴儿持续性动脉导管的治疗：早期和长期结果

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The hemodynamically relevant persistent ductus arteriosus (PDA) impairs pulmonary and cardiac function. Frequently, PDA can be closed only via surgery. In this retrospective study, early and long-term results in very low birth weight newborns are evaluated. Eighty-seven of 634 very low weight newborns presented with PDA All patients (pts; age:+-14 days; weight: +- 1064 g) were ventilator-dependent. Surgical closure (after 29+-5 days) was indicated if echocardiography and prolonged ventilation (> 20+-2 days) evidenced a hemodynamically relevant PDA. Sixteen pts, in which indomethacin therapy failed preoperatively are included in the 36 surgically treated pts; no pt died intra-or early postoperatively (<3 day). Overall mortality 30 days after delivery was n = 9. Early plus late mortality was n = 19. Long-term follow-up (3-12 years) in 46 (68%) pts: 15 were solely physically, 11 were mentally and neurologically, and 4 were physically, mentally and neurologically retarded. From these 30 pts, 15 were severely (e.g. tetraspasm; severe cerebral paresis) and 15 were slightly (e.g. psychosomatic and language development prolongation) retarded. Sixteen pts exhibited no disability; no long-term complications owing to surgery. The relatively large number of neurological injuries was not owing to chromosomal syndromes or pre-existing abnormalities but can be explained by severe and frequent prematurity, hypoxia, and intracerebral bleeding, Indomethacin was successful only in a few patients. Early surgery (after frustran early indomethacin therapy) of a hemodynamically relevant PDA is recommended. In the long-term, severe disabilities develop.
机译：血液动力学相关的持续性动脉导管（PDA）损害肺和心脏功能。通常，只能通过手术关闭PDA。在这项回顾性研究中，评估了出生体重非常低的新生儿的早期和长期结果。 634例极低体重新生儿中有87例患有PDA所有患者（点;年龄：+-14天;体重：+/- 1064 g）均依赖呼吸机。如果超声心动图和长时间通气（> 20 + -2天）证明有血流动力学相关的PDA，则表明手术关闭（29 + -5天后）。 36例接受手术治疗的患者中有16例术前吲哚美辛治疗失败。术中或术后早期（<3天）无患者死亡。分娩后30天的总死亡率为n =9。早期和晚期死亡率为n =19。46（68％）分的长期随访（3-12年）：仅身体上有15个，精神和神经上有11个，和4位在生理，心理和神经方面均处于发育迟缓状态。在这30分中，有15例严重（例如四痉挛;严重的脑瘫）而15例（例如心身和语言发育的延长）稍有延迟。 16名患者没有残疾。没有因手术而引起的长期并发症。相对大量的神经系统损伤不是由于染色体综合征或预先存在的异常所致，而是可以通过严重且频繁的早产，缺氧和脑内出血来解释，消炎痛仅在少数患者中成功。建议尽早进行与血流动力学相关的PDA的手术（在Frustran早期消炎痛治疗后进行）。从长远来看，严重的残疾会发展。

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