目的:探讨新生儿持续肺动脉高压（persistent pulmonary hypertension of newborn，PPHN）患儿在体外膜肺氧合（extracorporeal membrane oxygen，ECMO）治疗状态下动脉导管未闭（patent dental arteriosus，PDA）的治疗策略。方法:选择2012年7月至2019年12月解放军总医院第七医学中心儿童外科重症监护科收治的需要ECMO治疗的PPHN合并PDA新生儿为研究对象，通过心脏超声观察患儿在ECMO治疗过程中动脉导管分流的变化及治疗、预后情况。结果:共纳入符合条件患儿45例，男33例，女12例，ECMO治疗时日龄5.5（1.0，10.0） d，体重（3 320±490） g；其中动脉导管双向分流40例，右向左分流5例。ECMO治疗后48 h 动脉导管自然闭合30例，使用布洛芬药物关闭导管9例，药物无效改手术结扎4例，直接外科手术结扎2例。6例PDA结扎手术日龄（6.0±1.4） d，手术时间（90.0±42.4）min，无手术相关并发症死亡病例。顺利撤离ECMO 34例，顺利出院29例，放弃治疗5例，死亡11例。结论:ECMO治疗过程中患儿肺动脉压降低，多数患儿动脉导管自然闭合或经布洛芬治疗后闭合；对于持续开放的有显著血流动力学影响的PDA患儿，需要考虑外科手术，ECMO治疗下行PDA结扎手术是安全可行的。“,”Objective:To study the treatment strategies of neonatal patent ductus arteriosus (PDA) with persistent pulmonary hypertension of newborn (PPHN) during extracorporeal membrane oxygenation (ECMO) support.Method:Data of neonates with PDA and PPHN with ECMO support were collected from July 2012 to December 2019 in PICU of the Seventh Medical Center of the PLA General Hospital. The blood shunt of PDA before and during ECMO treatment were monitored by cardiac echo. The prognosis of these patients was recorded as well.Result:A total of 45 cases were involved in our study with 33 males and 12 females. The average body weight of the patients was (3 320±490) g and median ECMO initial age was 5.5(1.0,10.0) d. Bidirectional shunt at PDA level was noted in 40 cases, right-to-left shunt was found in the rest 5 cases. After initial 48 h of ECMO support, natural closure of PDA was found in 30 cases; 9 cases needed ibuprofen; the rest 6 cases required surgical ligation, among them 4 cases had prior ibuprofen but failed. The average age of all the cases received surgical ligation was (6.0±1.4) d and the average duration of surgical procedure was (90.0±42.4) min. No complications were observed during surgery. In the end, 34 neonates were successfully withdrawn from ECMO and 29 cases survived to discharge. Treatment was abandoned in 5 cases and 11 cases demised.Conclusion:As the reduction of pulmonary artery pressure during ECMO support, PDA could be closed naturally or by ibuprofen therapy. For those with persistent open PDA and hsPDA, surgical ligation should be considered. The surgical closure of PDA during the ECMO support is safe.