Clinical Analysis Of Patent Ductus Arteriosus In Premature Infants

Objective: The cases of premature infants with patent ductus arteriosus(PDA)in our hospital in recent 6 years were retrospectively analyzed to discuss the clinical and cardiac hemodynamic characteristics of hemodynamically significant PDA(hs-PDA),and to analyze its treatment and prognosis,so as to provide reference for the management of hs-PDA for premature infants.Method: Clinical data of premature infants with PDA admitted to the neonatal ward of the First Affiliated Hospital of Guangxi Medical University from January 2013 to December 2018 were retrospectively collected.All cases were divided into hs-PDA group and non-hemodynamically significant PDA(nhs-PDA)group according to their clinical manifestations and cardiac ultrasound results.General conditions,maternal pregnancy diseases,neonatal related diseases,common complications of premature infants and hemodynamics of each group were observed,and the differences between groups were compared with SPSS Statistics 16.0.Results:1.A total of 36 premature infants were included in this study,and the annual numbers of cases from 2013 to 2018 were: 2,4,8,2,4 and 16,respectively.The common complications occurred in premature infants were intraventricular hemorrhage(IVH)75.1%,bronchopulmonary dysplasia(BPD)38.9%,retinopathy of prematurity(ROP)25.0%,feeding intolerance 25.0%,gastrointestinal bleeding 13.9%,necrotizing enterocolitis(NEC)8.3%,and persistent fetal circulation(PFC)2.8%.2.The incidence of neonatal asphyxia,neonatal anemia,neonatal pneumonia and neonatal respiratory distress syndrome(NRDS)was higher in the hs-PDA group,but only the difference of neonatal asphyxia was statistically significant(P<0.05).3.In the hs-PDA group,the total duration of oxygen intake,duration of mechanical ventilation,days of parenteral nutrition application and days of hospitalization were longer,and the treatment cost was higher(P<0.05).ROP,BPD,PFC and gastrointestinal bleeding accounted for a higher proportion in the hs-PDA group,but only ROP showed statistical difference(P<0.05).4.In terms of physical signs,cardiac murmur and tachycardia were more common in the hs-PDA group,but only cardiac murmur was statistically different(P<0.05).The DA diameter,LA/AO and LV/AO of the hs-PDA group were significantly larger than those of the nhs-PDA group(P<0.05).Conclusions:1.Neonatal asphyxia may increase the risk of hemodynamic changes in premature PDA infants.2.hs-PDA may be associated with long oxygen intake,prolonged total enteral nutrition,long hospital stay,and the occurrence of ROP in premature infants,thus increasing the economic burden.3.hs-PDA should be paid attention to when the patients show signs of respiratory condition worsens,cardiac murmur,and cardiac enlargement,andcardiac ultrasound indicates that DA diameter,LA/AO,and LV/AO are relatively large,so that early treatment can reduce the occurrence of complications.