长疗程吲哚美辛治疗极低出生体重儿动脉导管开放疗效.doc

长疗程瞅嗥美辛治疗极低出生体重儿动脉 导管开放疗效 【摘要】目的：探讨延长眄I嗥美辛疗程治疗开放性动 脉导管（PDA ）的疗效和安全性。方法:46例合并PDA早产 儿病例随机分为口弓I唏美辛治疗组24例和布洛芬治疗组22 例。眄際美辛组每次口服眄W朵美辛0.2 mg/kg , 1次门2 h , 第3次服药后4?12 h复查心脏彩色多普勒,PDA关闭者不 再服药，未关闭者继续按原剂量服药两次，间隔时间相同， 第5次服药后4?12h再次复查心脏彩色多普勒。布洛芬组 首次给予10 mg/kg，第2、第3次分别为5 mg/kg ,每次间 隔24 h ,共服药3次，分别于第3次服药后4 ~ 12 h、32 ~ 36 h （相当于口引唏美辛组第5次服药后4 ~ 12 h ）复查心脏 彩色多普勒，治疗期间作血肌軒（SCr X血钠、血小板、血 清胆红素检查、记录尿量。比较两组的关闭率及副作用的发 生情况。结果：口弓際美辛组5次服药关闭率（95.83% ）较3 次服药关闭率（62.50% ）高，差异有统计学意义（P<0.05 ）, 口引唏美辛组和布洛芬组第3次服药后的关闭率分别为 62.50%和63.64% ,差异无统计学意义（P > 0.05 ）,而第5 次服药后(或相当时间)两组的关闭率分别为95.83%和 68.18%」引唏美辛组关闭率高于布洛芬组，差异有统计学意 义(PvO.05 ), 口引喙美辛组低钠和少尿例数高于布洛芬组, 差异有统计学意义(P < 0.05 ),而胆红素达到光疗标准例数 低于布洛芬组(PvO.05 b两组均无消化道出血和坏死性肠 炎发生。结论：延长口弓|口朵美辛疗程可以提高PDA关闭率, 未增加药物副作用。 【关键词】极低体重儿；开放性动脉导管；眄P朵美辛；布 洛芬 [Abstract ] Objective:To determine whether prolonged oral indomethacin treatment course is efficacious and safe in closure of patent ductus arteriosus (PDA) in very low birth weight (VLBW) infants. Methods:46 cases of premature infants with PDA confirmed by echocardiography whose gestational age small than 35 weeks, birth weight less than 1,500 g were divided into two groups? One group infants were treated by oral indomethacin (indomethacin group), another group infants were treated by ibuprofen (ibuprofen group). There were not significant difference in gestational age, gender, birth weight, age, and complication between the two groups .In indomethacin group infants, treatment was started with oral indomethacin 0.2 mg/kg body weight, followed by the same dose at 12 hours intervals. Then echocardiography was performed at 4 ?12 hours after the third time taking drug? If it was indicated that PDA closed, treatment was discontinued? Otherwise, two additional same doses were given. Echocardiography was performed again to confirm if PDA close or do not. In the ibuprofen group infants, all baby received oral ibuprofen suspension 10 mg/kg body weight for the first dose, followed at 24 hour intervals by 2 additional doses of 5 mg/kg ea