特発性呼吸窮迫症候群を伴う極小未熟児動脈管開存症 : 外科的結紮術の適応に関する検討

概要

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During the last 8 years, 31 premature infants developing respiratory distress, in whom the presence of patent ductus arteriosus (PDA) was confirmed, have been treated at the Kobe Children's Hospital. Eighteen patients weighed less than 1, 200 gm at birth (Group I). Of these 18 patients, 13 received medical management alone and 5 survived. Remaining 5 underwent ductus ligation. Of these patients, four had received indomethacine therapy prior to surgery. No mortality was seen related to surgery. Indomethacine therapy seems effective in about half of this group of patients. Thirteen patients weighing 1, 200-2, 000 gm at birth (Group II) received medical therapy alone. Ten patients survived. Of these 10 patients, four responded well to indomethacine. In other 4 patients, a spontaneous closure of PDA was observed and remaining 2 are with asymptomatic PDA. Our experience suggests that infants weighing more than 1, 200 gm will respond indomethacine respectively well and will rarely need surgery for PDA with respiratory distress. On the other hand, ligation of PDA should be considered in infants of less than 1, 200 gm of body weight, who do not respond to indomethacine therapy.
日本小児外科学会の論文