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动脉导管未闭早产儿的动脉导管关闭术:手术结扎与心导管介入封堵的对比分析。

Extremely premature infants with patent ductus arteriosus closure: Comparative analysis of surgical ligation versus cardiac catheterization-based closure.

机构信息

McGovern School of Medicine, University of Texas, Health Science Center at Houston, Houston, TX.

Phoenix Children's Hospital, Phoenix, AZ.

出版信息

Medicine (Baltimore). 2022 Mar 25;101(12):e29103. doi: 10.1097/MD.0000000000029103.

Abstract

Our objective was to compare postprocedure hemodynamic decompensation in extremely premature infants who had their patent ductus arteriosus (PDA) closed with surgical ligation (SL) versus cardiac catheter-based closure (CCC).This is a single-center retrospective review of extremely premature ( < 28 weeks) infants who had their PDA closed by SL or CCC.Of the total of 69 infants, 53 underwent SL, and 16 had CCC. Infants in 2 groups were comparable at birth. However, at the time of the procedure, infants in the SL group were smaller, less mature, and had higher respiratory support. Vasopressor use, both pre- and postprocedure, was more common in the SL group. Nineteen percent of the infants in the SL group, compared to 6% in the CCC group (P = .34), required dose escalation or use of vasopressors after the PDA closure.There was no significant difference between the 2 groups in postoperative hemodynamic decompensation. Large, multicenter, prospective study or randomized control trial will help to confirm our findings.

摘要

我们的目的是比较接受手术结扎(Surgical Ligation,SL)与经导管封堵(Cardiac Catheter-based Closure,CCC)关闭动脉导管未闭(Patent Ductus Arteriosus,PDA)的极度早产儿术后血液动力学失代偿的情况。这是一项回顾性单中心研究,纳入了接受 SL 或 CCC 关闭 PDA 的极度早产儿(<28 周)。共纳入 69 例婴儿,其中 53 例行 SL,16 例行 CCC。两组婴儿在出生时具有可比性。然而,在手术时,SL 组的婴儿更小、不成熟,呼吸支持更高。SL 组的血管加压素使用无论是术前还是术后都更为常见。与 CCC 组的 6%相比,SL 组的 19%婴儿(P =.34)在 PDA 关闭后需要增加剂量或使用血管加压素。两组术后血液动力学失代偿无显著差异。大规模、多中心、前瞻性研究或随机对照试验将有助于证实我们的研究结果。

相似文献

8
Patent ductus arteriosus ligation in premature infants in the United States.美国早产儿动脉导管未闭结扎术。
J Surg Res. 2014 Aug;190(2):613-22. doi: 10.1016/j.jss.2014.02.003. Epub 2014 Feb 12.

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