ABSTRACT
Objective To explore the experience of emergency operation for patent ductus arteriosus (PDA) in neonates and to assess the therapeutic effect.Methods The clinical data of 31 PDA neonates(15 male,16 female) treated in our department from July 2012 to February 2015 were reviewed retrospectively.Of these cases,28 were preterm infants and 3 were full term infants.Mean gestational age was 30+4 weeks ranging from 26+2 to 39 +3 weeks.Mean birth weight and weight at operation was(1 159.0 ± 729.2) g and (1 522.0 ± 644.5) g,respectively.We operated with left transaxillary straight incision in 6 cases and posterolateral minimal incision in 25 cases,and the pleural cavity was entered via the 4th intercostal space.All the neonates were divided into ＜ 1 500 g group(n =24) and ＞ 1 500 g group(n =7) by weight,the clinical prognosis were analysized.Results All 31 operations were finished successfully.No deaths occurred as a result of surgery.Average time of operation was (62.7 ± 29.9) min.Mean time of mchanical ventilation after the operation among survivors was (5.5 ± 4.7) d.The time of mechanical ventilation between ＜ 1 500 g group and ＞ 1 500 g group were (7.2 ± 2.3) d and (4.9 ± 2.4) d respectively,and there was significant difference between two groups(P ＜ 0.001).The time of hospital stay were (45.3 ± 11.0) d and (20.4 ± 14.5) d respectively between two groups (P ＞ 0.05).Twenty-eight cases recovered and released from the hospital successfully.Two cases quited the treatment themselves and 1 succumbed to death because of heart failure,hyperkalemia and arrhythmia.ConclusionEmergency surgical closure is a safe and effective method for the treatment of neonatal large PDA,especially with congestive heart failure,a variety of complications,long time ventilator dependence,medical treatment failure,which should be ligatured timely as it can have severe influence on the cardiopulmonary function.After ligation the abnormal shunt will disappear and the cardiopulmonary function will be better.It is helpful to extubate ventilators and improve the survival rates.
ABSTRACT
Introdução: Com os recentes avanços tecnológicos e nos cuidados oferecidos às gestantes e recém-nascidos, a mortalidade neonatal tem diminuído de forma consistente. Por outro lado, a sobrevivência de crianças cada vez mais prematuras e de menor peso ao nascimento tem sido acompanhada por um aumento significativo da morbidade neurológica nesta faixa etária. Diversos estudos sugerem que a administração de sulfato de magnésio pré-natal às gestantes com doença hipertensiva específica da gestação reduziria o risco de hemorragia peri-intraventricular (HPIV) e suas complicações. Objetivo: Comparar a ocorrência de HPIV em um grupo de recém-nascidos cujas mães receberam sulfato de magnésio e outros em que as gestantes não receberam esta medicação. Métodos: Estudo de delineamento retrospectivo, realizado através da análise de prontuários do serviço de arquivo médico de um hospital terciário do município de Curitiba. Conclusão: Os dados coletados e analisados em nosso estudo não demonstram diferença estatisticamente significativa entre os grupos para "tipo de parto" (p=0,44), "idade materna" (p=0,81), "peso de nascimento" (p=0,30) e "escore de Apgar no quinto minuto de vida" (p=0,23). Também não observamos associação entre a administração de sulfato de magnésio nas 72 horas que antecederam o parto e a ocorrência de HPIV nestes prematuros (p=0,58)...
Subject(s)
Humans , Male , Female , Child , Cerebral Hemorrhage , Infant, Premature , Magnesium SulfateABSTRACT
Objective To study the effect of cleaning intestinal tract on treatment jaundice in premature infants.Methods We randomly assigned 48 premature infants from January to December in 2004.In the treatment group the intestinal tract was cleaned with 30～40 mL NS once daily and 3～4 days.The through cutis bilirubin(TCB),the times of blue light,me conium exhustion and feeding toleration were recorded.Results 1.The TCB was obviously descented about 34.2 ?mol/L and the time of blue light was shortened by 20 h in treated group(P