极早产儿血流动力学显著的动脉导管未闭管理的研究进展
Advance in Management of Hemodynamically Significant Patent Ductus Arteriosus for Extremely Preterm Infants
DOI: 10.12677/acm.2026.1631115, PDF,   
作者: 李 菲, 史 源*：重庆医科大学附属儿童医院新生儿科，儿童少年健康与疾病国家临床医学研究中心，重庆
关键词: 早产儿；动脉导管未闭；评估；管理；Preterm Infants； Patent Ductus Arteriosus； Evaluation； Management
摘要: 动脉导管未闭(patent ductus arteriosus, PDA)是早产儿、尤其极低出生体重儿中最常见的心血管问题之一，而血流动力学显著的动脉导管未闭(Hemodynamically significant patent ductus arteriosus, HsPDA)的存在或持续与早产儿多种严重并发症的发生密切相关，造成早期或晚期不良预后结局。尽管多年来，关于早产儿PDA的研究从未停止，但目前国内外对于HsPDA的评估、治疗仍存在争议，不同临床中心对于PDA的评估及实践管理仍存在较大的异质性，尤其在是否治疗以及治疗时机方面的选择显示出较大差异。故本文回顾现有的研究证据，对极早产儿HsPDA的病理生理、评估及干预管理进行综述。
Abstract: Patent ductus arteriosus (PDA) is one of the most common congenital cardiovascular anomalies in preterm infants, particularly those with very low birth weight (VLBW). The presence or persistence of Hemodynamically significant patent ductus arteriosus (HsPDA) is closely related to the occurrence of a variety of serious complications in preterm infants, resulting in early or late poor prognostic outcomes. Although extensive research on PDA in preterm infants has been conducted over recent decades, consensus remains lacking regarding standardized diagnostic criteria, risk stratification approaches, and therapeutic decision-making—including indications for pharmacologic or interventional closure and optimal timing of intervention. Moreover, considerable inter-center variability persists in the evaluation and management of PDA, especially concerning treatment initiation and timing. This review synthesizes current evidence to outline the pathophysiology, diagnostic assessment, and contemporary management strategies for HsPDA in extremely preterm infants.
文章引用：李菲, 史源. 极早产儿血流动力学显著的动脉导管未闭管理的研究进展[J]. 临床医学进展, 2026, 16(3): 3094-3102. https://doi.org/10.12677/acm.2026.1631115

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