2024-03-28T14:46:38Z
https://u-ryukyu.repo.nii.ac.jp/oai
oai:u-ryukyu.repo.nii.ac.jp:02016038
2022-10-31T07:49:07Z
1642838163960:1642838198944:1642838199408:1642838213103
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[原著]未熟児,新生児期PDA手術症例の検討: 外科的治療の立場から
Surgical treatment of patent ductus arteriosus in premature neonates
久貝, 忠男
知花, 幹雄
仲間, 司
天久, 憲治
Kugai, Tadao
Chibana, Mikio
Nakama, Tsukasa
Ameku, Kenji
open access
琉球医学会
premature infant
surgical ligation
indomethacin
Efficacy of surgical closure versus intravenous indomethacin therapy for treatment of patent ductus arteriosus (PDA) in low-birth-weight premature infants and neonates is an ongoing controversy. In an attempt to develop criteria for surgical closure of PDA in premature infants and neonates, we reviewed our experiance at our hospital. From May 1990 to Octobar 1998, 20 premature infants and neonates underwent surgical closure for symptomatic PDA in our hospital. Surgical closure of PDA as the primary treatment was in 5 infants. The remaining 15 patients who failed indomethacin therapy underwent surgical ligation of their PDA. On the other hand, for the purpose of comparison of surgical closure with the pharmacologic treatment, seventeen infants who were initially treated with intravenous indomethacin therapy from January 1996 to October 1998, were reviewed. Finally, among the infants receiving indomethacin, 41% (7/17) of these infants required surgical intervention. The overall operative mortality was 5%. Surgical morbidity included ductal injury (1 patient). There were no operation-related death. Those infants who failed indomethacin therapy, i.e., those with a persistent ductus, had a general weighted loss, marked compromise of nutritional status and required a prolonged ventilatory support. Moreover, there is a high mortality when necrotizing enterocolitis (NEC) occurs. We conelude that those infants who failed indomethacin therapy should be immediately submitted to surgical ligation of PDA, because a ligation of PDA is ultimately safer and easier and improves the condition of those with heart and respiratory failure.
論文
琉球医学会
Ryukyu Medical Association
1999
jpn
journal article
VoR
http://hdl.handle.net/20.500.12000/0002016038
https://u-ryukyu.repo.nii.ac.jp/records/2016038
1346888X
0289-1530
AN10369445
琉球医学会誌 = Ryukyu Medical Journal
19
1
17
20
https://u-ryukyu.repo.nii.ac.jp/record/2016038/files/v19p17.pdf