Brandt B, Marvin W J, Ehrenhaft J L, Heintz S, Doty D B
Ann Thorac Surg. 1981 Aug;32(2):166-72. doi: 10.1016/s0003-4975(10)61026-0.
In the operating room, 66 preterm infants weighing between 710 and 2,700 gm (23 less than 1,000 gm) underwent ligation of a patent ductus arteriosus (PDA). Respiratory distress syndrome was present in 53 patients; the rest had apnea-bradycardia syndrome. PDA ligation was indicated for intractable congestive heart failure in 52 patients or progressive respiratory failure in 14. There were no intraoperative deaths. Fifteen infants died 1 to 120 days postoperatively. Seven deaths resulted from intracranial bleeding, 3 from diffuse coagulopathy, and 1 from respiratory failure. The condition of patients with heart failure improved postoperatively, with the mean left atrium to aorta ratio reduced from 1.56 to 1.02 (p = 0.05). Respiratory function improved in 25 patients extubated by the third postoperative day. Late follow-up (one to five years) of the 51 survivors showed 1 late death. Seventeen survivors had roentgenographic evidence of bronchopulmonary dysplasia. Infants with bronchopulmonary dysplasia required longer postoperative ventilation (mean, 21.5 days compared with 4.75 days). Twenty-four infants were normal. Ligation of PDA in preterm infants has low intraoperative risk and improves the condition of those with heart and respiratory failure. Late follow-up showed good recovery of nearly two-thirds of the patients.
在手术室，66名体重在710至2700克之间（23名体重不足1000克）的早产儿接受了动脉导管未闭（PDA）结扎术。53例患者存在呼吸窘迫综合征；其余患者患有呼吸暂停-心动过缓综合征。52例患者因难治性充血性心力衰竭或14例因进行性呼吸衰竭而进行PDA结扎术。术中无死亡病例。15名婴儿在术后1至120天死亡。7例死于颅内出血，3例死于弥散性凝血障碍，1例死于呼吸衰竭。心力衰竭患者术后病情改善，左心房与主动脉平均比值从1.56降至1.02（p = 0.05）。25例术后第3天拔管的患者呼吸功能改善。对51名幸存者的晚期随访（1至5年）显示有1例晚期死亡。17名幸存者有支气管肺发育不良的影像学证据。患有支气管肺发育不良的婴儿术后需要更长时间的通气（平均21.5天，而正常婴儿为4.75天）。24名婴儿情况正常。早产儿PDA结扎术术中风险低，可改善心力衰竭和呼吸衰竭患者的病情。晚期随访显示近三分之二的患者恢复良好。
