法莫替丁治疗新生儿应激性溃疡的疗效及安全性

Efficacy and safety of famotidine for the treatment of stress ulcers in neonates

目的探讨法莫替丁治疗新生儿应激性溃疡的疗效和安全性。方法该院2001～2006年共收治新生儿应激性溃疡54例,其中7例经胃镜证实。采用法莫替丁0.5mg/kg静脉注射,每12h一次,待止血和胃pH升至4.5～6后改为每天给药1次,连用2d。同时治疗原发病和合并症以消除应激的病因。监测症状消失的时间和动态监测应用法莫替丁前、后的胃液pH值,统计治愈率;同时监测法莫替丁可能出现的不良反应以及是否增加其他伴用药物的毒性。结果应用法莫替丁后96.3%的患儿于24h以内止血、止吐,100%于48h以内止血、止吐;胃液pH均值由用药前的2.07±0.22上升并保持在5.01～5.15;用药后呼吸、心率、血压无明显变化,未发现纳差、恶心、呕吐、腹泻、便秘、皮疹等及其他不良反应;用药前、后的白细胞和血小板计数和肝脏酶学检查均无统计学差异;亦未见增加同时应用的其他药物的毒副作用,最后全部治愈。结论法莫替丁用于治疗新生儿应激性溃疡,疗效好,而且安全。

Objective To investigate the efficacy and safety of famotidine treatment for stress ulcers in neonates. Methods Fifty-four neonates with stress ulcers from 2001 to 2006 were enrolled. Seven cases were confirmed with stress ulcers by gastroseopy. Famotidine was administered intravenously at a dosage of 0. 5 mg/kg every other 12 hrs. After cessation of hematemesis and vomiting, famotidine was administered once a day for two days. Primary diseases and complications were concurrently treated. Clinical symptoms and gastric pH were assessed before and after famotidine treatment. Possible adverse effects of famotidine treatment-related were observed. Results After 24 hrs of famotidine treatment, hematemesis and vomiting ceased in 52 patients （96.3%）. Clinical symptoms disappeared in all of the 54 patients 48 hrs after famotidine treatment. Gastric pH value increased 6, 12, 24, 36 and 48 hrs after famotidine treatment from 2.07 ± 0.22 （ before treatment） to 5.01 - 5.15 （ P 〈 0. 01 ）. All of the 54 patients were successfully treated. Famotidine treatment did not lead to abnormal respiration, heart rate and blood pressure. Loss of appetite, nausea, vomiting, diarrhea, constipation and rashes were not seen after famotidine treatment. There were significant differences in white cell count, platelet count and hepatic enzyme levels before and after famotidine treatment. An augmented side effect of the other drugs concurrently used due to famotidine treatment was not noted. Conclusions Famotidide is effective and safe for the treatment of stress ulcers in neonates.