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目的:探讨口服布洛芬治疗早产儿动脉导管未闭(PDA)的临床疗效及利弊。方法:选择2008年3月~2009年1月经心脏彩超确诊为PDA的早产儿,口服布洛芬混悬液10 mg/kg,24 h后口服5 mg/kg,3剂一疗程。用药期间监测心率、血压、血氧饱和度(SaO2)、血糖、尿量,复查血常规、肾功能,并观察有无喂养不耐受,坏死性小肠结肠炎(NEC)及颅内出血等倾向。治疗结束后第7天复查心脏彩超并完善头颅CT,生后4周行早产儿视网膜病变(ROP)筛查。结果:布洛芬关闭PDA的有效率为86%,同时NEC发生率明显下降,但慢性肺部疾病发生率却明显增加,脑室内出血及早产儿视网膜病变(ROP)发生率无明显差异。结论:口服布洛芬治疗早产儿动脉导管未闭安全、有效,并能减少NEC的发生。
Objective: To investigate the clinical efficacy and advantages and disadvantages of oral ibuprofen in the treatment of patent ductus arteriosus (PDA) in preterm infants. Methods: Preterm infants diagnosed with PDA by heart color Doppler ultrasonography from March 2008 to January 2009 were enrolled in this study. Oral ibuprofen suspension 10 mg / kg was given orally 5 mg / kg after 24 hours for 3 courses. Heart rate, blood pressure, blood oxygen saturation (SaO2), blood glucose, urine output, blood routine examination, renal function and monitoring of feeding intolerance, necrotizing enterocolitis (NEC) and intracranial hemorrhage were monitored during treatment. On the 7th day after the treatment, the echocardiography was performed and the skull CT was completed. The retinopathy of prematurity (ROP) screening was performed 4 weeks after birth. Results: The effective rate of ibuprofen closure of PDA was 86%, while the incidence of NEC was significantly decreased. However, the incidence of chronic pulmonary disease was significantly increased. The incidence of intraventricular hemorrhage and retinopathy of prematurity (ROP) showed no significant difference. Conclusions: Oral ibuprofen is safe and effective in treating patent ductus arteriosus in preterm infants and can reduce the incidence of NEC.