미숙아와 신생아의 동맥과 개존증에 대한 수술요법(소개흉 결찰술과 흉강경 보조하의 clipping과의 비교)

  • 장지원 (이화여자대학교 흉부외과학교실) ;
  • 한재진 (이화여자대학교 흉부외과학교실) ;
  • 원용순 (가톨릭 대학교 대전 성모병원 흉부외과학교실) ;
  • 원태희 (이화여자대학교 흉부외과학교실) ;
  • 안재호 (이화여자대학교 흉부외과학교실) ;
  • 박영식 (이화여자대학교 흉부외과학교실) ;
  • 최수승 (이화여자대학교 흉부외과학교실)
  • Published : 2000.01.01

Abstract

Background: This study was aimed at analyzing the preoperative conditions post-operative results indication and methods of surgical closure of patent ducturs arterio년 in prematures low birth weight infants and neonates. Patients and Methods: We retro-spectively studied two groups of patients (prematures group and neonates group) who underwent surgical closure of the patent ductus arteriosus between March 1995 and June 1998. Results: The premature group consisted of 9 patients(3 males and 6 females) Their mean gestational period was 30.7 weeks(ranging from 26 weeks to 33 weeks) mean age 27.8 days(11 days to 55 days) and mean body weight 1.56 kg. Prominent preoperative symptoms were dependency on mechanical ventilation generalized edema and hepatomegaly. We performed PDA ligation via thoracotomy in all premature patients. The neonate group consisted of 16 patients and their mean body weight was 3.75 kg. Major symptoms of this group was tachypnea and intercostal retraction resistant to medical treatment. We performed video-assisted PDA clipping to them all. There were no postoperative complications or operation-related mortality in both groups. Comparing the ratio of size of PDA(mm)/body weight(kg) the ratio of premature group (ligation through thoracotomy) was higher than that of neonate group ( video-assisted clipping) that is 3,89:1.21(p=0.03) Conclusion : We conclude that the surgical closure of PDA can be a safe method of treatment for prematures low birth weight infants and neonates with compromised general conditions. Choice of surgical technique depends on the surgeon's preference but there was a tend-ency to choose the ligation method through thoracotomy for patients with small body weight and large PDA.

Keywords

References

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