早产儿动脉导管未闭手术结扎的研究进展

Research advances in surgical ligation of patent ductus arteriosus in premature infants

动脉导管未闭(patent ductus arteriosus,PDA)是早产儿最常见的心血管疾病之一。持续动脉导管开放会造成早产儿死亡率及并发症发病率显著增加。对于具有持续血流动力学意义的PDA,若药物治疗失败或药物使用禁忌,手术结扎PDA是一个必要的治疗选择。本文将对PDA手术结扎风险与益处、手术结扎常见并发症、手术结扎后血流动力学改变等方面进行详细阐述,并基于手术结扎PDA前后病理生理学改变,对围手术期管理提出优化建议。

Patent ductus arteriosus(PDA)is one of the most common cardiovascular abnormality in premature infants.Prolonged non-closure of ductus arteriosus is associated with a significant elevation of mortality.Surgery is required for a large hemodynamically significant PDA(hsPDA)when medical treatment is ineffective or contraindicated.Here the risks and benefits of PDA surgical ligation,common complications of surgical ligation and hemodynamic changes after surgical ligation were detailed.Coping strategies for perioperative optimization were proposed along with a physiology-based algorithm for postoperative management.