Beitzke A, Rigler B, Müller W D, Metzler W, Schober P
Helv Paediatr Acta. 1980 Oct;35(5):459-70.
In a 13-month period, ligation of the persistent ductus was carried out in 23 prematurely born babies with severe respiratory distress syndrome who were all respirator-dependent. Mean gestational age was 30.6 weeks (26-36 weeks), mean birth weight 1490 g (850-3090 g) with 3 patients under 1000 g. Signs of cardiac failure by large left to right shunt via ductus were seen at the end of the first week of life, radiologic signs as pulmonary edema were seen 1 to 2 days earlier. Mean age at operation was 13.5 days (4-27 days), mean duration of artificial ventilation 22 days (8-59 days). Indomethacin was used orally 12 of these patients without effect to close the ductus. One patient died of cerebral hemorrhage on his 17th day of life, 10 days postoperatively, one 3 1/2 months later at home with porencephaly and hydrocephalus. Four patients show radiologic signs of bronchopulmonary dysplasia. In the following 6 months up to December 1979, another 15 patients with IRDS underwent ductus ligation. Gestational age and birth weights were about the same as in the first group. Out of this second group which has not been followed up for a longer period. 3 babies died. Early mortality in both groups is 10.5% (4 out of 38 patients).
在13个月的时间里,对23例患有严重呼吸窘迫综合征且均依赖呼吸机的早产婴儿进行了动脉导管未闭结扎术。平均胎龄为30.6周(26 - 36周),平均出生体重1490克(850 - 3090克),其中3例体重低于1000克。出生后第一周结束时可见通过动脉导管由左向右大量分流导致的心力衰竭体征,而肺水肿的放射学体征则提前1至2天出现。手术时的平均年龄为13.5天(4 - 27天),人工通气的平均持续时间为22天(8 - 59天)。其中12例患者口服吲哚美辛试图关闭动脉导管,但未起效。1例患者在出生后第17天,即术后10天死于脑出血;1例在3个半月后在家中因孔洞脑和脑积水死亡。4例患者有支气管肺发育不良的放射学体征。在接下来直到1979年12月的6个月里,又有15例患有呼吸窘迫综合征的患者接受了动脉导管结扎术。胎龄和出生体重与第一组大致相同。第二组未进行更长时间的随访,有3例婴儿死亡。两组的早期死亡率均为10.5%(38例患者中有4例)。