布洛芬治疗早产儿动脉导管未闭53例临床研究.docVIP

布洛芬治疗早产儿动脉导管未闭53例临床研究 　　【摘要】 目的 探讨口服布洛芬治疗早产儿动脉导管未闭(PDA)的疗效以及安全性,同时研究相关因素对疗效影响。方法 符合入选标准的PDA患儿53例给予口服布洛芬治疗,观察患儿动脉导管关闭情况以及不良反应。结果 本组首次治疗有效率为84.91%,治疗失败者8例,经第2疗程治疗后有2例PDA关闭,因此,PDA关闭总有效率为88.68%。研究表明布洛芬的用药时间和患儿出生体重对PDA关闭率均有积极显著的影响,且无严重不良反应发生。结论 布洛芬治疗早产儿动脉导管未闭疗效确切,用药安全。早期应用布洛芬,可显著提高早产儿的PDA关闭率。 　　【关键词】 动脉导管未闭;布洛芬;早产儿 　　Ibuprofen Treatment in 53 Premature Infants of Patent Ductus Arteriosus 　　LIU Wang-kai,SU Yi-hua,SHEN Zhen-yu.Department of Pediatrics,First Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510080,China 　　【Abstract】 Objective To explore the efficacy and safety of ibuprofen in patent ductus arteriosus(PDA)treatment in premature infants,and investigate correlation factors that effected the efficacy.Methods 53 cases of PDA that matched the selected standards were treated with ibuprofen orally.The closure of ductus arteriosus and adverse reactions were under observation.Results Effective power of first treatment in our research was 84.91%,8 cases failed.Two cases of PDA were closed after the second course of treatment.The total effective rate was 88.68%.This research also indicated that the time to use ibuprofen and the birth weight of children were of positive and notable effect on closure rate of PDA.No serious adverse reaction occurred during the research.Conclusion Ibuprofen in PDA treatment is safe and of certain efficacy.It can obviously elevate the rate of PDA closure in premature infants to use ibuprofen early. 　　【Key words】 Patent ductus arteriosus; Ibuprofen; Premature infant 　　 　　动脉导管未闭(Patent ductus arteriosus,PDA)是早产儿常见的先天性心脏病,是主动脉和肺动脉间的一种先天性异常通道,常可诱发或促进充血性心衰、慢性肺疾病、颅内出血等疾病发生发展,是严重影响早产儿存活率和后遗症发生率的主要原因。国内外文献报道表明吲哚美辛可有效治疗早产儿PDA,但不良反应发生率偏高,限制其临床应用。近年来临床报道布洛芬悬液口服治疗早产儿PDA有肯定的临床效果,但其安全性以及用药的影响因素还存在争议。为了进一步探讨口服布洛芬的疗效以及安全性,笔者应用布洛芬治疗早产儿PDA 53例,同时研究相关因素对疗效影响。 　　1 资料与方法 　　1.1 临床资料 　　病例选择2006年6月至2009年6月本院新生儿科收治的早产儿PDA患儿53例,入选标准符合:胎龄≤35周,出生体重≤2000 g,住院时间60×10?9/L;无少尿、活动性出血、坏死性小肠结肠炎(NEC)等治疗禁忌证。其中男婴36例,女婴17例;胎龄27~34周;出生体重 900~2000 g。排除合并房间隔缺损、室间隔