CAJ | 학술논문

目的：探讨早产儿动脉导管未闭(PDA)外科手术治疗的临床经验。方法回顾性分析2011年8月~2013年8月本院接受外科手术治疗的早产PDA患儿共19例，所有病例心前区均可闻及收缩期杂音，术前超声动脉导管直径3~6 mm，平均(3.6±0.5)mm。其中口服布洛芬关闭2次均失败7例，术前行机械通气治疗8例。对其术中、术后情况进行总结分析。结果手术时间为35~55 min，平均(48.0±15.3)min，术中均未输血。术后均行机械通气，时间为1~10 d，平均(3.5±2.3)d，撤机后均于3 d内离氧。术后行心脏超声检查均未见残余分流。术后7~20 d出院，平均(11.0±3.0)d。所有患儿术中、术后均无大出血。全组患儿无死亡，均痊愈出院。结论对早产儿PDA引发临床症状者及内科保守治疗无好转者，早期外科手术治疗是安全有效的治疗方法。
목적：탐토조산인동맥도관미폐(PDA)외과수술치료적림상경험。방법회고성분석2011년8월~2013년8월본원접수외과수술치료적조산PDA환인공19례，소유병례심전구균가문급수축기잡음，술전초성동맥도관직경3~6 mm，평균(3.6±0.5)mm。기중구복포락분관폐2차균실패7례，술전행궤계통기치료8례。대기술중、술후정황진행총결분석。결과수술시간위35~55 min，평균(48.0±15.3)min，술중균미수혈。술후균행궤계통기，시간위1~10 d，평균(3.5±2.3)d，철궤후균우3 d내리양。술후행심장초성검사균미견잔여분류。술후7~20 d출원，평균(11.0±3.0)d。소유환인술중、술후균무대출혈。전조환인무사망，균전유출원。결론대조산인PDA인발림상증상자급내과보수치료무호전자，조기외과수술치료시안전유효적치료방법。
Objective To discuss the clinical experience of surgical operation in treatment of patent ductus arteriosus (PDA) in preterm infants. Methods 19 cases of preterm infants with PDA in the hospital from August 2011 to August 2013 were reviewed and analyzed,and were accepted surgical operation treatment.Systolic murmur could be heard in precordium,diameter of arterial duct by preoperative ultrasound was 3 to 6 mm,averaging of (3.6±0.5) mm.Among the infants,2 cases were oral administration ibuprofen closure unsuccessful,8 cases were mechanical ventilation treatment before operation.The preterm infants condition of the intraoperative and postoperative was summarized. Results The time of operation was 35 to 55 min,average of (48.0±15.3) min,during the operation there was no transfusion.Postoperation, mechanical ventilation treatment was adopted about 1 to 10 days,average of (3.5±2.3) days.All infants left oxygen after weaning in 3 days.After operation the detection of ultrasound showed no residual shunt.Infants left hospital after 7 to 20 days treatment,average of (11.0±3.0) days.All of infants were cured,there was no massive hemorrhage and no death occurred during and after the operation. Conclusion For the preterm infants of PDA induced clinical symptoms and treated by conservative medicine unsuccessfully,the early surgical operation treatment of PDA in premature infants is safe and effective.