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1、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0.2mg/kg,1次门2h,第3次服药后4〜12h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10mg/kg，第2、第3次分别为5mg/kg,每次间隔24h,共服药3次，分别于第
2、3次服药后4~12h、32~36h（相当于口引唏美辛组第5次服药后4~12h）复查心脏彩色多普勒，治疗期间作血肌軒（SCrX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
3、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.05b两组均无消化道出血和坏死性肠炎发生。结论：延长口弓
4、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:Todeterminewhetherprolongedoralindomethacintreatmentcourseisefficaciousandsafein
5、closureofpatentductusarteriosus(PDA)inverylowbirthweight(VLBW)infants.Methods:46casesofprematureinfantswithPDAconfirmedbyechocardiographywhosegestationalagesmallthan35weeks,birthweightlessthan1,500gweredividedintotwogroups・Onegroupinfantsweretreatedbyoralindometh
6、acin(indomethacingroup),anothergroupinfantsweretreatedbyibuprofen(ibuprofengroup).Therewerenotsignificantdifferenceingestationalage,gender,birthweight,age,andcomplicationbetweenthetwogroups.Inindomethacingroupinfants,treatmentwasstartedwithoralindomethacin0.2mg/k
7、gbodyweight,followedbythesamedoseat12hoursintervals.Thenechocardiographywasperformedat4〜12hoursafterthethirdtimetakingdrug・IfitwasindicatedthatPDAclosed,treatmentwasdiscontinued・Otherwise,twoadditionalsamedosesweregiven.Echocardiographywasperformedagaintoconfirmi
8、fPDAcloseordonot.Intheibuprofengroupinfants,allbabyreceivedoralibuprofensuspension10mg/kgbodyweightforthefirstdose,followedat24hourintervalsby2additionaldosesof5mg/kgeach・EchocardiographywasperformedtodetermineifPDAcloseordonotat4~42hours32〜36hoursafterthethirdti
9、metakingdrug・Serumsodium,serumcreatinine,plateletcount,serumbilirubinweremeasuredandurineoutputwasrecordedduringtreatmentcourse・Results:Theclosurerateafterthef
