动脉导管未闭的预防措施对极早产儿有用吗？
Is the prophylaxis of patent ductus arteriosus useful in extremely premature infants?
作者信息
Bersani Iliana, De Carolis Maria Pia, Lacerenza Serafina, De Rosa Gabriella, Fusco Francesca Paola, Cota Francesco, Romagnoli Costantino
机构信息
Division of Neonatology, Catholic University of Sacred Heart, Rome, Italy.
出版信息
Turk J Pediatr. 2011 Mar-Apr;53(2):187-93.
This study was aimed to verify the efficacy and safety of ibuprofen prophylaxis of patent ductus arteriosus in very preterm infants, in order to select infants receiving higher benefits from this intervention. Two hundred neonates with gestational age (GA) < or = 28 weeks receiving ibuprofen within the first two hours of life were included. Ductus closure rate was 68%, and results were significantly dependent on GA (48.8% among neonates with GA < 26 weeks vs 73.2% among those with GA > or = 26 weeks, p < 0.01). Neonates with GA < 26 weeks showed a lower ductus closure after the primary course of therapy (20% vs 57.5%, p < 0.01), as well as higher reopening rate (16.2% vs 3.8%, p < 0.05) and need for surgical ligation (38.8% vs 5.8%, p < 0.01). During the prophylaxis period, 11 neonates (5.5%) showed pulmonary hypertension. Considering risks/benefits, we recommend prophylaxis only in infants with GA < 26 weeks.
本研究旨在验证布洛芬预防极早产儿动脉导管未闭的疗效和安全性，以便选择能从该干预措施中获得更大益处的婴儿。纳入了200例胎龄（GA）≤28周且在出生后两小时内接受布洛芬治疗的新生儿。动脉导管闭合率为68%，结果明显取决于胎龄（GA＜26周的新生儿中为48.8%，而GA≥26周的新生儿中为73.2%，p＜0.01）。GA＜26周的新生儿在初始治疗疗程后动脉导管闭合率较低（20%对57.5%，p＜0.01），再通率较高（16.2%对3.8%，p＜0.05），且手术结扎需求较高（38.8%对5.8%，p＜0.01）。在预防期间，11例新生儿（5.5%）出现肺动脉高压。综合风险/益处考虑，我们建议仅对GA＜26周的婴儿进行预防。
Zotero 插件