Influence analysis of ductus arteriosus diameter on complications of HsPDA in premature infants
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摘要: 目的 探讨早产儿具有血流动力学改变的动脉导管未闭(HsPDA)与无血流动力学改变的PDA (nHsPDA)并发症的差异,以及不同内径组HsPDA并发症的差异。 方法 采用回顾性分析研究的方法,选取2017年1月—2018年12月在中国科技大学附属第一医院NICU住院的早产PDA患儿71例,按照有无血流动力学改变分为HsPDA组和nHsPDA组,其中,HsPDA组又按照动脉导管内径大小分为大中小型3组,数据采用列联表独立性Fisher检验、t检验分析。 结果 nHsPDA组20例,HsPDA组51例,大型HsPDA组(>3.0 mm)15例、中型HsPDA组(1.5~3.0 mm)34例、小型HsPDA组(<1.5 mm)2例;HsPDA组[(2.67±0.97) mm]与nHsPDA[(1.77±0.75) mm]组的动脉导管内径大小差异有统计学意义(P<0.001);HsPDA组与nHsPDA组在性别、胎龄分布、体重、Apgar评分、多胎以及干预措施(PS、机械通气)方面差异无统计学意义(均P>0.05)。HsPDA组与nHsPDA组的并发症发生率差异无统计学意义(均P>0.05)。大中小型HsPDA的并发症发生率差异无统计学意义(均P>0.05),但大型HsPDA组ROP (7/15,46.67%)、IVH (4/15,26.67%)发生率均高于中小型组。不同内径对HsPDA出院前动脉导管是否关闭无显著影响。 结论 HsPDA组较nHsPDA组的平均动脉导管内径大,但对并发症无显著影响;不同动脉导管内径组HsPDA的并发症发生率差异无统计学意义;PDA优先采用保守支持治疗,必要时采取药物或手术封堵。
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关键词:
- 血流动力学改变的动脉导管未闭 /
- 早产儿 /
- 动脉导管内径 /
- 并发症
Abstract: Objective To investigate the difference of the complications between hemodynamic significant patent ductus arteriosus(HsPDA) and non-hemodynamic PDA(nHsPDA) in premature infants, and the complications of HsPDA in different diameter groups. Methods Using the method of retrospective analysis, 71 premature infants with PDA hospitalized in NICU of the First Affiliated Hospital of University of science and technology of China from January 2017 to December 2018 were divided into HsPDA group and nHsPDA group according to the hemodynamic changes. Among them, HSPDA group was divided into large, medium and small groups according to the diameter of the ductus arteriosus. Data were analyzed using Fisher test for independence in a contingency table and t-test. Results There were 20 cases in nHsPDA group and 51 cases in HsPDA group, which included 15 cases in large HsPDA group(>3 mm), 34 cases in medium HsPDA group(1.5-3.0 mm), and 2 cases in small HsPDA group(<1.5 mm). There was significant difference in the diameter of ductus arteriosus between HsPDA group [(2.67±0.97) mm] and nHsPDA [(1.77±0.75) mm, P<0.001]. There was no significant difference in gender, age distribution, body weight, Apgar score, multiple births and intervention(PS, mechanical ventilation) between HsPDA group and nHsPDA group(all P>0.05). There was no significant difference in the incidence of complications between HsPDA group and nHsPDA group(P>0.05). There was no significant difference in the incidence of complications between the large, medium and small HsPDA groups(P>0.05), but the incidence of ROP(7/15, 46.67%) and IVH(4/15, 26.67%) in the large HsPDA group were higher than those in the small and medium HsPDA group. There was no significant effect of different diameter on closure of ductus arteriosus before discharge of HsPDA. Conclusion The average diameter of ductus arteriosus in HsPDA group is larger than that in nHsPDA group, but there is no significant effect on complications. There is no significant effect on complications of HsPDA with different diameter of ductus arteriosus. Patients with PDA should be treated with conservative support, and drug or surgical closure should be used if necessary.
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