早产儿动脉导管未闭结扎术后心肺功能障碍的危险因素分析。

Q3 Medicine

中国当代儿科杂志 Pub Date : 2025-04-15 DOI:10.7499/j.issn.1008-8830.2411050

Chong-Chong Liu, Yong Liu, Yi Zhang, Dai-Cheng Han, Rui-Jing He, Shi-Wen Xia

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引用次数: 0

摘要

目的：探讨早产儿血流动力学意义显著的动脉导管未闭结扎术后发生心肺功能障碍的危险因素。方法：回顾性收集胎龄为6岁的早产儿的临床资料。结果：logistic回归分析显示，术前平均增重速度较快，术前1周内游离三碘甲状腺原氨酸（FT3）水平较低（P11.45 g/(kg·d)， FT3水平较低）是hsPDA结扎术后发生心肺功能障碍的危险因素。术前1周内平均增重率超过11.45 g/（kg·d）、FT3水平低于2.785 pmol/L是影响hsPDA结扎术后心肺功能的危险因素。术前应加强评估和干预，减少术后并发症的发生。

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[Risk factors for cardiopulmonary dysfunction after ligation of hemodynamically significant patent ductus arteriosus in preterm infants].

Objectives: To investigate the risk factors for the occurrence of cardiopulmonary dysfunction following ligation of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants.

Methods: A retrospective collection of clinical data was conducted on preterm infants with a gestational age of <34 weeks who were admitted to the Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology from January 2018 to August 2024. These infants underwent hsPDA ligation after 1-2 courses of failed ibuprofen treatment. Based on the occurrence of blood pressure changes and oxygenation or ventilation failure postoperatively, the infants were divided into a cardiopulmonary dysfunction group (19 cases) and a non-cardiopulmonary dysfunction group (40 cases). Binary logistic regression analysis was performed to explore risk factors for postoperative cardiopulmonary dysfunction.

Results: Binary logistic regression analysis indicated that a faster average weight gain rate preoperatively and low levels of free triiodothyronine (FT₃) within one week before surgery were risk factors for cardiopulmonary dysfunction following hsPDA ligation (P<0.05). Receiver operating characteristic curve analysis showed that an average weight gain rate >11.45 g/(kg·d) and FT₃ levels <2.785 pmol/L within one week before surgery had predictive value for postoperative cardiopulmonary dysfunction (P<0.05). The combination of these two indicators provided the highest predictive value (P<0.05), with an area under the curve of 0.825, a sensitivity of 79%, and a specificity of 75%.

Conclusions: An average weight gain rate exceeding 11.45 g/(kg·d) and FT₃ levels below 2.785 pmol/L within one week before surgery are risk factors affecting cardiopulmonary function after hsPDA ligation. Preoperative assessment and intervention should be strengthened to reduce the risk of postoperative complications.

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来源期刊

中国当代儿科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

1.50

自引率

0.00%

发文量

5006

期刊介绍： The Chinese Journal of Contemporary Pediatrics (CJCP) is a peer-reviewed open access periodical in the field of pediatrics that is sponsored by the Central South University/Xiangya Hospital of Central South University and under the auspices of the Ministry of Education of China. It is cited as a source in the scientific and technological papers of Chinese journals, the Chinese Science Citation Database (CSCD), and is one of the core Chinese periodicals in the Peking University Library. CJCP has been indexed by MEDLINE/PubMed/PMC of the American National Library, American Chemical Abstracts (CA), Holland Medical Abstracts (EM), Western Pacific Region Index Medicus (WPRIM), Scopus and EBSCO. It is a monthly periodical published on the 15th of every month, and is distributed both at home and overseas. The Chinese series publication number is CN 43-1301/R；ISSN 1008-8830. The tenet of CJCP is to “reflect the latest advances and be open to the world”. The periodical reports the most recent advances in the contemporary pediatric field. The majority of the readership is pediatric doctors and researchers.