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正常足月儿生后24-48h动脉导管已呈功能性关闭,而早产儿的动脉导管常不能关闭,或功能性关闭后又重新开放。有呼吸窘迫综合征的极低出生体重儿,生后第3天动脉导管未闭(PDA)的发生率约为40％。PDA的临床结果取决于左向右分流的程度,可加重呼吸窘迫、促发充血性心力衰竭、支气管肺发育不良、肾脏低灌注及脑缺血、继发肠缺血。70％胎龄小于28周的早产儿需要药物或手术关闭动脉导管。手术结扎动脉导管有血压波动、感染、乳糜胸、喉神经麻痹,甚至死亡的危险。故在大多数新生儿重症监护病房中,药物治疗PDA是首选。
Normal term neonates 24-48 hours after the birth of the patent ductus arteriosus has been closed, and premature infants can often be closed catheter, or functional closure and reopened. Very low birth weight infants with respiratory distress syndrome have a prevalence of patent ductus arteriosus (PDA) of approximately 40% on day 3 of life. The clinical outcome of PDAs depends on the extent of left-to-right shunting, which can exacerbate respiratory distress, trigger congestive heart failure, bronchopulmonary dysplasia, renal hypoperfusion and cerebral ischemia, followed by intestinal ischemia. 70% of premature infants less than 28 weeks of gestation require medication or surgery to close the ductus arteriosus. Surgical ligation of arterial catheter blood pressure fluctuations, infection, chylothorax, laryngeal nerve paralysis, and even the risk of death. Therefore, in most neonatal intensive care units, drug-treated PDA is the first choice.