摘要
目的探讨动脉导管持续开放对早产儿的影响和危害。方法采用回顾性调查研究,选择2007—2010年我院新生儿科住院治疗的动脉导管未闭(PDA)早产儿,根据出院时或死亡前动脉导管关闭情况分为动脉导管关闭组和动脉导管持续开放组。比较两组早产儿相关并发症的发生情况、氧疗情况、预后及住院费用等多方面的差异。结果动脉导管持续开放组(59例)发生充血性心力衰竭、喂养不耐受和Ⅲ～Ⅳ级脑室内出血的比例、需要呼吸支持的比例及用氧时间均高于动脉导管关闭组(112例),差异有统计学意义[50.8%比32.1%,33.9%比17.9%,8.5%比0.9%,66.4%比32.1%,7.0天(3.0,13.0)比6.0天(0,9.8),P均<0.05];两组发生NEC、Ⅰ～Ⅱ级脑室内出血、支气管肺发育不良和早产儿视网膜病的比例差异无统计学意义(P>0.05)。导管持续开放组住院时间和住院费用均多于动脉导管关闭组[(26.3±14.9)天比(20.0±12.9)天,(21079±13166)元比(17761±10849)元,P均<0.05]。结论动脉导管持续开放可使早产儿相关并发症增加,对呼吸支持的要求增多,也增加了住院时间和费用。
Objective To examine the affects and clinical outcomes of persistent patent ductus arteriosus（PDA） on preterm infants.Methods A total of 171 preterm infants who were diagnosed and admitted into our hospital NICU between Jan.2007 and Dec.2010 were recruited for this retrospective study.Two groups were formed based on the following PDA status：Group one consisted of 59 neonates with persistent PDA,whereas group two had 112 neonates with closed PDA.Complication rates between the two groups included congestive heart failure（CHF）,bronchopulmonary dysplasia（BPD）,neonatal necrotizing enterocolitis（NEC） and intraventricular hemorrhage（IVH） which were compared.Oxygen usage,clinical outcomes and the cost of hospitalizations were also compared.Results In patients with persistent PDA,higher incidence of CHF（50.8% vs.32.1%,P=0.017） and grade Ⅲ-Ⅳ IVH（8.5% vs.0.9%,P=0.033）,poorer tolerance to feeding（33.9% vs.17.9%,P=0.018）,more need for respiratory support（64.4% vs.32.1%,P=0.000） and longer duration of oxygen therapy（average 13.0 d vs.3.0 d,P=0.036） were found when compare to those with closed ductus.However,there was no statistical difference（P0.05） in the incidence of NEC,grade Ⅰ-Ⅱ IVH,BPD and retinopathy of prematurity（ROP） occurrence as well as the infant mortality rate.When the financial burdens were compared,there were also longer hospital stays [（26.3±14.9） d vs.（20.0±12.9） d,P=0.002] and higher hospitalization costs [（21 079±13 166） RMB vs.（17 761±10 849） RMB,P=0.039] among patients with persistent PDA.Conclusions Failure of ductal closure leads to increased incidence of complications,higher needs for respiratory support,prolonged duration for hospitalization and greater financial burden.
出处
《中国新生儿科杂志》
CAS
2012年第2期82-85,共4页
Chinese Journal of Neonatology
关键词
动脉导管未闭
婴儿
早产
并发症
住院时间
住院费用
Patent ductus arterious
Infant
premature
Complications
Length of stay
Hospital costs
