Hernández Díaz Carlos, Ruiz Hierro Cristina, Ortega Escudero Marta, Montero García Jacobo, Galvañ Felix Yaiza, Martínez Díaz Sara, Suárez Fernández Joaquin
Servicio de Cirugía Pediátrica, Hospital Universitario de Burgos, Burgos, España.
Servicio de Cirugía Pediátrica, Hospital Universitario de Burgos, Burgos, España.
An Pediatr (Engl Ed). 2019 Oct;91(4):251-255. doi: 10.1016/j.anpedi.2018.12.014. Epub 2019 Feb 15.
Patent ductus arteriosus (PDA) is considered a risk factor for necrotising enterocolitis (NEC) and other gastrointestinal complications in preterm infants. The aim of this study is to determine whether there is a higher incidence of abdominal surgery and the associated morbidity and mortality in preterm infants who require treatment due to a significant PDA.
An observational study was conducted that included preterm infants with <37 weeks of gestational age, and a diagnosis of PDA in the last 10 years. Depending on the treatment received, the patients were divided into 3 groups: medical (A), medical and surgical (B), and no treatment (C). An analysis was performed on the pre- and peri-natal variables, as well as the incidence of gastrointestinal complications (NEC, and need for surgery for this reason), and overall mortality.
The study included a sample of 144 patients, of whom 91 were assigned to group A, 16 to B, and 37 to C. The mean gestational age by groups was 28, 26.7, and 30.1 weeks, respectively. The mean birth weight was 1083.9 gr, 909.3 gr, and 1471.2 gr, respectively. As regards the incidence of NEC, a total of 21, 5, and 5 cases, respectively, were found in each group, with 43%, 60% and 35%, respectively requiring abdominal surgery. Mortality by groups was 12%, 19%, and 3%, respectively CONCLUSION: Patients who required treatment for a significant PDA had a higher incidence of gastrointestinal complications and higher mortality than untreated patients, with no statistically significant differences being found. In the group of patients that required treatment, lower gestational age and birth weight, could explain the increase in morbidity and mortality found in these patients.
动脉导管未闭（PDA）被认为是早产儿坏死性小肠结肠炎（NEC）及其他胃肠道并发症的一个危险因素。本研究的目的是确定因严重PDA而需要治疗的早产儿腹部手术的发生率以及相关的发病率和死亡率是否更高。
进行了一项观察性研究，纳入孕周小于37周且在过去10年内诊断为PDA的早产儿。根据接受的治疗，将患者分为3组：药物治疗组（A）、药物及手术治疗组（B）和未治疗组（C）。对产前和围产期变量、胃肠道并发症的发生率（NEC以及因此需要手术的情况）和总体死亡率进行了分析。
该研究纳入了144例患者样本，其中91例被分配到A组，16例到B组，37例到C组。各组的平均孕周分别为28周、26.7周和30.1周。平均出生体重分别为1083.9克、909.3克和1471.2克。关于NEC的发生率，每组分别发现21例、5例和5例，分别有43%、60%和35%需要进行腹部手术。各组的死亡率分别为12%、19%和3%。结论：因严重PDA而需要治疗的患者胃肠道并发症发生率和死亡率高于未治疗的患者，但未发现统计学上的显著差异。在需要治疗的患者组中，较低的孕周和出生体重可以解释这些患者中发病率和死亡率的增加。
