Massone M L, Soliani M, Puccio V, Bracco G, Forcheri C, Pongiglione G, Bava G, Magnano G M, Toma P
Unità di Terapia Intensiva Neonatale, Istituto G. Gaslini, Genova.
Minerva Anestesiol. 1990 May;56(5):179-83.
Surgical closure of patent ductus arteriosus (PDA) and perioperative time have been proposed as conditions of increased risk of peri-intraventricular hemorrhage (PVH-IVH) in preterm infants. We examined by pre- and postoperative ultrasound (US) scan 15 low birth-weight neonates who underwent PDA ligation within the first two weeks of life. They were assessed with regard to clinical state, perioperative management and development of PVH-IVH. Fourteen did not show onset or extension of intracranial hemorrhage in the immediate postoperative period. One patient developed a wide III grade IVH in the 24 perioperative hours. His conditions were particularly severe, suggesting that many factors such as acidosis, hypoxia, hypercapnia and hypotension might have combined to lead to hemorrhage. We conclude that PDA ligation is not likely to increase the risk of PVH-IVH per se.
手术闭合动脉导管未闭(PDA)及围手术期时间被认为是早产儿发生脑室内周围出血(PVH-IVH)风险增加的条件。我们通过术前和术后超声(US)扫描检查了15例在出生后两周内接受PDA结扎术的低体重新生儿。对他们进行了临床状态、围手术期管理及PVH-IVH发生情况的评估。14例在术后即刻未出现颅内出血的发作或扩展。1例患者在围手术期24小时内发生了广泛的III级IVH。他的病情特别严重,提示酸中毒、缺氧、高碳酸血症和低血压等多种因素可能共同导致了出血。我们得出结论,PDA结扎术本身不太可能增加PVH-IVH的风险。