经皮导管介入封堵与外科结扎治疗早产儿动脉导管未闭的发病率和神经发育结局 2 年随访。
Morbidity and neurodevelopmental outcomes at 2 years in preterm infants undergoing percutaneous transcatheter closure vs. surgical ligation of the PDA.
机构信息
Sunrise Children's Hospital, Las Vegas, NV, USA.
The Regional Neonatal ICU Maria Fareri Children's Hospital at Westchester Medical Center - New York Medical College Valhalla, Valhalla, NY, USA.
出版信息
J Perinatol. 2024 Oct;44(10):1454-1462. doi: 10.1038/s41372-024-02019-w. Epub 2024 Jun 3.
OBJECTIVE
Review a cohort of preterm infants ≤29 weeks of gestation at birth and compare morbidities and neurodevelopmental outcomes based on PDA status and type of PDA closure.
STUDY DESIGN
Single center observational retrospective-prospective case control study of premature infants who had no hsPDA, underwent surgical ligation or percutaneous transcatheter closure of the PDA. Neurodevelopmental testing was done using the Bayley Scales of Infant Development 3rd ed.
RESULTS
The percutaneous transcatheter closure group had an older post menstrual age and greater weight at the time of procedure, and started enteral feeds and achieved room air status at an earlier post procedure day. Infants in the surgical ligation group were more likely to experience vocal cord paralysis. There was no difference in neurodevelopmental outcomes between groups.
CONCLUSION
Waiting for infants to achieve the appropriate size for percutaneous transcatheter closure of the PDA may lead to reduced short-term complications without increasing the risk of neurodevelopmental impairment.
目的
回顾≤29 周胎龄的早产儿队列，并根据 PDA 状态和 PDA 关闭类型比较发病率和神经发育结局。
研究设计
对无 hsPDA、接受 PDA 手术结扎或经皮导管介入关闭的早产儿进行单中心观察性回顾性前瞻性病例对照研究。使用贝利婴幼儿发育量表 3 版进行神经发育测试。
结果
经皮导管介入封堵组的校正胎龄和手术时体重较大，且术后更早开始肠内喂养并达到室内空气状态。手术结扎组的婴儿更有可能出现声带麻痹。两组在神经发育结局方面无差异。
结论
等待婴儿达到适合经皮导管介入封堵 PDA 的大小可能会减少短期并发症，而不会增加神经发育障碍的风险。
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