摘要
目的：观察预防性口服布洛芬关闭极低体重儿动脉导管未闭（PDA）的疗效及安全性。方法：将74例极低体重儿随机分成预防组32例。生后6h内予以口服布洛芬悬液；另42例作为对照组不予布洛芬口服，如临床出现PDA征象和/或心脏彩超证实有PDA存在，再予以布洛芬治疗。两组患儿7-10d后心脏彩超检查观察PDA关闭率，并观察布洛芬的不良反应及并发症。结果：预防组PDA关闭率为90．62％，对照组为78．57％，对照组中9例有PDA者经布洛芬治疗后5例关闭。最终PDA关闭率达90．47％，两组比较差异无统计学意义；预防组17例（53．13％）在首剂后即出现少尿，2例因出现无尿而停药。对照组6例（14．28％）出现少尿，差异有统计学意义（P〈0．05）；入院时血酐（Cr）预防组（71．67±9．24）μmol／L，对照组（73．26±9．53）μmol／L，差异无统计学意义（P〉0．05）；第4d 血肌酐预防组（89．02±21．86）μmol／L。对照组（69．12±11．35）μmol／L，差异有统计学意义（P〈0．05）；两组坏死性小肠姑肠炎（NEC）、胃出血发病率无统计学意义，但预防组喂养不耐受（FI）发病率高，达全胃肠道喂养时间（FEF）长，差异有统计学意义（P〈0．05）；两组脑室内出血（IVH）、慢性肺部疾病（CLD）、病死率、血小板比较差异无统计学意义。结论：极低体重儿7-10d PDA自然关闭率高，布洛芬早期用药增加了极低体重儿脏器损伤的风险，临床出现PDA后再予以布洛芬治疗可能更合理、更安全。
Objective：To study the clinical effect and safety of preventive oral ibuprefen on patent ductos arteriosus in very low birth weight infant. Methods： 74 cases were divided into a preventive group of 32 eases with oral ibuprofcn and a control group of 42 cases without oral ibuprofen unless the symptoms of patent ductus arteriosus appeared and/or were detected by the color doppler. Results： The closing rate in the prevention group was 90.62%, and in the control group was 78.57%. PDA was dosed in 5 cases after treatment in 9 cases with PDA. At last, the closing rate in the control group was 90.47%, then the closing rate in the two groups had no significant difference （P 〉 0.05）. In the prevention group, oliguria [urine output 〈 1 mL/（kg·h） ] occurred in 17 cases （53.13%） after the first dose, anuria in 2 eases and the medicine was stopped. Oliguria in the control group occurred in 6 cases （14.28%）. The two groups had a significant difference （P 〈 0.05）. Serum creatinine （71.67 ± 9.24） in preventive group vs in the control group （73.26 ± 9.53） （ P 〉 0.05） on the 1st day in hospital showed no obvious difference, and （89. 02±21.86） vs （69.12±11.35） （P 〈 0.01） on the 4th day was an obvious difference. Two groups had no significant difference in necrotizing enterocolitis, gastric haemorrhage, intraventrieular hemorrhage （IVH）, chronic lung disease （CLD）, death rate, and blood plate had, but the days of reaching full enteral feeding （FEF） and feeding intolerance （FI） had significant difference. Conclusions： The natural closing rate of patent duetus arteriosus was high in very low birth weight infant of 7 - 10days. Preventive group increased risk of organ injury in very low birth weight infaint, but the treatment of oral ibuprofen was more rational and safe after patent duetua arteriosus appears.
出处
《儿科药学杂志》
CAS
2006年第6期10-12,共3页
Journal of Pediatric Pharmacy
关键词
极低体重儿
动脉导管未闭
布洛芬
预防
Very low birth weight infant
Patent duetus arteriosus
Ibuprofen
Prevention
