动脉导管未闭(PDA)的早产儿伴有呼吸窘迫综合征(RDS)的处理在过去几年中成了热烈争论的问题。鉴于RDS的症状严重,病情多变,故不易估计PDA在自然病程中的影响。这样,治疗方法也就难于掌握。一般认为:对无症状的小量左向右分流的婴儿不需处理,这种PDA几乎肯定会自然关闭而不需要以后作外科结扎术。众所公认,少数RDS患儿的病程中有大量左向右导管分流的明显体征:脉搏强而有力、心脏扩大、肺充血,超声心动图显示左房扩大,并且需要长期的呼吸支持疗法。有些病例在获得初步改善后又须再用人工换气的措施。这些病例中,很多经过药物处理后充血性心力衰竭获得改善,但另一些病例需要手术关闭未闭的动脉导管。有一部分 The treatment of premature infants with patent ductus arteriosus (PDA) accompanied by respiratory distress syndrome (RDS) has been a subject of considerable controversy over the past few years. In view of the severe symptoms of RDS, his condition changing, it is not easy to estimate the impact of PDA in the natural course. In this way, the treatment is difficult to grasp. It is generally accepted that asymptomatic infants with a small left-to-right shunting need not be treated, the PDA will almost certainly close without the need for surgical ligation later on. It is generally acknowledged that there are numerous signs of left-to-right catheter shunting in the course of a minority of RDS children: pulsatile and powerful, enlarged heart, pulmonary congestion, and echocardiography with enlarged left atrium and long-term respiratory supportive therapy. In some cases, after preliminary improvements, they must be resuscitated manually. In these cases, many have been treated with medication to improve congestive heart failure, while others require surgery to close the patent ductus arteriosus. a part of it