Early or Late Surgical Ligation of Medical Refractory Patent Ductus Arteriosus in Premature Infants

• Main Authors: Chien-Chou Hsiao, 蕭建洲
• Other Authors: Weng-Cheng Chang
• Format: Others
• Language: zh-TW
• Published: 2009
• Online Access: http://ndltd.ncl.edu.tw/handle/10892574746212430185

碩士 === 長榮大學 === 醫學研究所 === 97 === Optimal time to surgical ligation of Patent ductus arteriosus (PDA) in very low birth weight (< 1500 gm) premature infants remains an area of controversy. We compare the outcomes of early or late ligation of medical refractory PDA in very low birth weight premature infants Between January 2001 and December 2003, fifty-six very low birth weight (<1500 gm) premature infants born at Morgan Stanley Children’s Hospital of New York underwent surgical closure of PDA after failure or having contraindication of medical treatment. According to the days of surgery, subjects were divided into early ligation group (≤14 days, n=13) and late ligation group (>14 days, n=43). Basic clinical features, major morbidities of premature and mortality of these two groups were compared. The clinical features and major outcomes of these two groups were similar. The important differences between these two groups were that early ligation group had earlier onset of symptomatic PDA (5.7±1.6 days versus 8.1±3.6 days, P=0.024), fewer days of total parenteral nutrition (TPN) use (39.6±13.9 days versus 60.4±31.4 days, P=0.025) and ventilator use (11.1±6.7 days versus 18.6±10.5, P=0.019). Early ligation of medical refractory PDA in very low birth weight premature infants will improve enteral feeding tolerance and shorten the TPN and ventilator use, but long term benefits need to be further investigation.