口服布洛芬治疗早产低体重儿动脉导管未闭临床疗效观察

Observation on the clinical effect of oral administration of ibuprofen in treatment of patent ductus arteriosus in preterm low birth weight infants

目的:探究布洛芬在治疗早产低体重儿动脉导管未闭(PDA)的临床疗效。方法:将该院近年来收治的152例早产低体重PDA患儿随机分为实验组和对照组,每组76例,实验组于生后24 h内口服布洛芬,首剂10 mg/kg,第2、3剂5 mg/kg。对照组给予安慰剂生理盐水1 ml/kg,第2、3剂0.5 ml/kg,每剂间隔24 h。观察两组患儿的治疗效果及不良反应。结果:第1疗程结束后实验组PDA关闭率为82.89%,高于对照组的42.11%,平均住院时间也短于对照组,两组比较差异有统计学意义(P<0.05)。实验组脑室周围白质软化,早期肺出血和支气管肺发育不良的发生率低于对照组(P<0.05),但两组脑室内出血和坏死性小肠结肠炎的发生率等差异无统计学意义(P>0.05)。结论:口服布洛芬治疗早产低体重儿PDA患者时可以明显提高动脉导管的关闭率,缩短住院时间,值得临床推广。

Objective： To explore the clinical effect of oral administration of ibuprofen in treatment of patent ductus arteriosus （PDA） in preterm low birth weight infants. Methods： A total of 152 premature low birth weight infants with PDA treated in the hospital in recent years were randomly divided into experimental group and control group, 76 infants in each group. The infants in experimental group were treated with oral administration of ibuprofen within 24 hours after birth, the first dose was 10 mg/kg, both the second dose and the third dose were 5 mg/kg. The infants in control group were treated with placebo （ normal saline）, the first dose was 1 ml/kg, both the second dose and the third dose were 0. 5 ml/kg, the time intervals of treatment in the two groups were 24 hours. The therapeutic efficacies and ad- verse reactions in the two groups were observed. Results： After the first course of treatment, PDA closure rates in experimental group was 82. 89%, which was higher than that in control group （42. 11% ）, the average hospitalization time in experimental group was shorter than that in control group, there were statistically significant differences between the two groups （P 〈 0. 05） . The incidence rates of periventricular leukomalacia, early pulmonary hemorrhage and bronchopulmonary dysplasia in experimental group were statistically significantly lower than those in control group （P 〈 0.05）, but there was no statistically significant difference in the incidence rates of intraventricular hemorrhage and necrotizing enterocolitis between the two groups （P 〉 0. 05） . Conclusion： Oral administration of ibuprofen can significantly improve PDA closure rate and shorten the hospitalization time in treatment of premature low birth weight infants with PDA, which is worth clinical promotion.