Alan Serdar, Karadeniz Cem, Okulu Emel, Kılıc Atila, Erdeve Omer, Ucar Tayfun, Atasay Begum, Atalay Semra, Arsan Saadet
Department of Pediatrics-Neonatology and.
J Matern Fetal Neonatal Med. 2013 Dec;26(18):1850-4. doi: 10.3109/14767058.2013.801956. Epub 2013 Jun 10.
The objective of this study was to find out the percentage of preterm infants that needed treatment for patent ductus arteriosus (PDA), when treatment decision was based on clinical signs and symptoms, besides echocardiographic findings.
Daily echocardiographic evaluation was conducted in 39 preterms ≤29(6/7) weeks' gestation. Patients with ductus arteriosus were closely followed-up for clinical symptoms of PDA for treatment decision until ductus arteriosus was closed either spontaneously or by treatment.
PDA was found in 25 (64%) infants. Mean gestational age and birth weight (BW) of the patients with PDA were 27.8 ± 1.2 and 998 ± 221 g, respectively. PDA closed spontaneously or had minimal ductal shunting before any signs and symptoms attributable to PDA were observed in 16 (41%) infants. Mean ductus size/BW ratio and mean left atrial/aortic root ratio were significantly higher in 9 (23%) symptomatic patients (2.06 ± 0.75 versus 1.32 ± 0.75 mm, p = 0.012 and 1.31 ± 0.52 versus 1.19 ± 0.2 mm, p = 0.043, respectively). PDA closure was observed after the first dose of ibuprofen in six of nine patients.
Correlation of clinical signs with echocardiographic findings for the decision of PDA treatment can be appropriate to prevent unnecessary medical treatments.
本研究的目的是找出基于临床体征和症状以及超声心动图检查结果决定治疗时，需要治疗动脉导管未闭（PDA）的早产儿百分比。
对39例孕周≤29（6/7）周的早产儿进行每日超声心动图评估。对患有动脉导管未闭的患者密切随访PDA的临床症状以决定治疗，直至动脉导管未闭自行闭合或通过治疗闭合。
25例（64%）婴儿发现有PDA。患有PDA的患者的平均孕周和出生体重（BW）分别为27.8±1.2周和998±221g。16例（41%）婴儿在观察到任何可归因于PDA的体征和症状之前，PDA自行闭合或仅有轻微导管分流。9例（23%）有症状的患者的平均导管大小/BW比值和平均左心房/主动脉根比值显著更高（分别为2.06±0.75对1.32±0.75mm，p = 0.012；1.31±0.52对1.19±0.2mm，p = 0.043）。9例患者中有6例在首次服用布洛芬后观察到PDA闭合。
临床体征与超声心动图检查结果相关联以决定PDA治疗，可能有助于避免不必要的医疗治疗。
