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2011年至2022年23至32周妊娠出生婴儿动脉导管未闭的管理:儿童医院新生儿联盟报告

Management of the patent ductus arteriosus among infants born at 23 to 32 weeks' gestation between 2011 to 2022: a report from in the Children's Hospitals Neonatal Consortium.

作者信息

Weems Mark F, Ball Molly K, Zaniletti Isabella, Habib Sharifa, Hamrick Shannon, Grover Theresa R, Keene Sarah, Murthy Karna, Padula Michael, Philip Ranjit, Rao Rakesh, Sen Shawn, Levy Philip T, Gowda Sharada H

机构信息

University of Tennessee Health Science Center and Le Bonheur Children's Hospital, Memphis, TN, USA.

The Ohio State University and Nationwide Children's Hospital, Columbus, OH, USA.

出版信息

J Perinatol. 2025 Mar 15. doi: 10.1038/s41372-025-02257-6.

Abstract

OBJECTIVE

This study reports on patent ductus arteriosus (PDA) therapy trends across the Children's Hospital Neonatal Consortium.

STUDY DESIGN

We performed a 12-year (2011-2022) retrospective study of premature infants (< 33 weeks) with a PDA. We utilized descriptive statistics to compare demographic, inpatient, and discharge characteristics in 3-year epochs.

RESULT

From 54,813 infants, 19,843 (36%) had a diagnosis of PDA. Use of pharmacotherapy increased 44% (relative) over time, mostly with increased acetaminophen use. There was a 12.7-fold increase in exposure to multiple PDA medications over the study period. While the rate of definitive closure did not change, use of transcatheter PDA closure increased from 0 to 20.3% and surgical ligation decreased from 25.1% to 3.6%.

CONCLUSION

There has been an increase in the use of multiple pharmacotherapies for PDA, especially among infants born <27 weeks' gestation. Transcatheter PDA closure has overtaken surgical ligation as the primary method of definitive PDA closure.

摘要

目的

本研究报告了儿童医院新生儿联盟中动脉导管未闭(PDA)的治疗趋势。

研究设计

我们对患有动脉导管未闭的早产儿(<33周)进行了为期12年(2011 - 2022年)的回顾性研究。我们使用描述性统计方法来比较3年时间段内的人口统计学、住院和出院特征。

结果

在54,813名婴儿中,19,843名(36%)被诊断为动脉导管未闭。随着时间的推移,药物治疗的使用增加了44%(相对),主要是对乙酰氨基酚的使用增加。在研究期间,接受多种动脉导管未闭药物治疗的比例增加了12.7倍。虽然确定性闭合率没有变化,但经导管动脉导管未闭封堵术的使用从0增加到20.3%,手术结扎从25.1%下降到3.6%。

结论

用于动脉导管未闭的多种药物治疗的使用有所增加,尤其是在孕周<27周出生的婴儿中。经导管动脉导管未闭封堵术已取代手术结扎成为动脉导管未闭确定性闭合的主要方法。

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