预防性口服布洛芬关闭极低体重儿动脉导管未闭的临床研究.DOCVIP

临床医学论文-预防性口服布洛芬关闭极低体重儿动脉导管未闭的临床研究 ????????? 作者： 张玲玲? 王建宏 ，杨晓红，丁玲利 ? 【关键词】? 极低体重儿;动脉导管未闭;布洛芬;预防 ????? ［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（P0.05）;入院时血肌酐（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（P0.05）;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（P0.05）;两组坏死性小肠结肠炎（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（P0.05）;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。 ??? ［关键词］ 极低体重儿;动脉导管未闭;布洛芬;预防 ??? The clinical study of preventive oral ibuprofen to patent ductus arteriosus in very low birth weight infant ??? ZHANG Ling-ling ??? 1 ，WANG Jian-hong ??? 1 ，YANG Xiao-hong ??? 2 ，et al （1.The Third Peoples Hospital ofWenzhou，Zhejiang Wenzhou 325000，China;2.The Peoples Hospital of Lishui，Zhejiang Province，Zhejiang Lishui 323000，China） ??? ［Abstract］ Objective:To study the clinical effect and safety of preventive oral ibuprofen on patent ductus arteriosus in very low birth weight in-fant.Methods:74cases were divided into a preventive group of32cases with oral ibuprofen and a control group of42cases 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 was90.62%，and in the control group was78.57%.PDA was closed in5cases after treatment in9cases with PDA.At last，the closing rate in the control group was90.47%，then the closing rate in the two groups had no significant difference（P0.05）.In the prevention group，oliguria［urine output1mL.（kg?h）］occurred in17cases（53.13%）after the first dose，anuria in2cases and the medicine was stopped.Oli-guria in the control group occurred