极低体重早产儿动脉导管未闭的床旁外科治疗  

Bedside surgery of patent ductus arteriosus in very low birth weight premature infants

作　　者：安育林[1] 周更须[1] 王辉[1] 刘宇航[1] 

机构地区：[1]北京军区总医院附属八一儿童医院,100700

出　　处：《中国循证心血管医学杂志》2013年第2期180-181,共2页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨极极低体重早产儿动脉导管未闭(PDA)床旁外科治疗的临床效果。方法纳入24例诊断PDA的极低体重早产儿,行床旁开胸PDA结扎术,从术前准备、麻醉管理及手术方法三个方面分析极低体重早产儿床旁PDA手术的特点及临床疗效。结果 24例极低体重早产儿床旁手术均取得成功,平均手术时间为(30.8±12.5)min,出血量平均为(10.5±4.6)ml,呼吸机辅助平均时间为(6.4±2.5)d。术后平均动脉压均有不同程度升高,脉压增大。所有患儿术后顺利拔除气管插管,围术期无意外及明显并发症发生。术后6个月所有患儿均无动脉导管再通和肺炎发作。结论对于极低体重早产儿,实施床旁PDA手术安全可行。Objective To discuss the curative effect of bedside surgery of patent ductus arteriosus （ PDA ） in very low birth weight （ VLBW ） premature infants. Methods VLBW premature infants （ n=24 ） with PDA of congenital heart disease were chosen and give bedside open chest ligation surgery. The characteristics and curative effect of the surgery were analyzed from the aspects of preoperative preparation, anesthesia management and surgical method. Results The bedside surgery was successful in all 24 cases, and the average operation time was （ 30.8 ± 12.5 ） minutes, average bleeding quantity was （ 10.5 ± 4.6 ） ml and average ventilation time of breathing machine was （ 6.4 ± 2.5 ） days. After the operation, the mean arterial pressure increased in varying degrees, and pulse pressure increased too. All infants were extubated smoothly and there were no perioperative accidents and remarkable complications. There were no arterial ductus recanalization and pneumonia in all infants 6 months after the operation. Conclusion For VLBW premature infants, bedside surgery of PDA is safe and feasible.

关 键 词：极低体重儿 早产儿 动脉导管未闭 床旁手术 

分 类 号：R726.2[医药卫生—儿科]