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奥曲肽在新生儿中的应用:病例系列。

Octreotide Use in Neonates: A Case Series.

机构信息

Monash Newborn, Monash Children's Hospital, Clayton, VIC, Australia.

Monash Newborn, Monash Children's Hospital, & Department of Paediatrics, Monash University, 246 Clayton Road, Clayton, VIC, Australia.

出版信息

Drugs R D. 2018 Sep;18(3):191-198. doi: 10.1007/s40268-018-0237-9.

Abstract

BACKGROUND AND OBJECTIVE

Octreotide is a somatostatin analogue and has been used off-label for a variety of conditions. There are no specific guidelines for the use of octreotide in neonates and its safety and efficacy have not been systematically evaluated. The objective of this study is to present our experience of using octreotide therapy in neonates.

METHODS

This is a retrospective study of neonates who received octreotide therapy during their hospital stay over a 15 years period (2003-2017) in a tertiary neonatal centre. The demographic details and indications of octreotide therapy including time of initiation, route, dose, duration and adverse effects of therapy were noted. The clinical course following octreotide administration was also analysed.

RESULTS

Eleven neonates received octreotide therapy during the study period, of which nine had chylothorax and two had chylous ascites. Resolution of the chylous effusion with octreotide therapy was achieved in 4 out of 11 (36.3%) of the cases. The median duration of octreotide therapy in cases with successful resolution was 17.5 days. With the exception of minor side effects such as hyperglycaemia, none of the patients had any significant side effects that required discontinuation of therapy.

CONCLUSION

Octreotide was used safely as an adjunctive therapy for the treatment of chylothorax and chylous ascites in neonates. However, larger prospective controlled trials are required to establish the optimal dose, time of initiation, duration and efficacy of octreotide therapy in neonates.

摘要

背景与目的

奥曲肽是一种生长抑素类似物,已被超适应证用于多种疾病。目前尚无奥曲肽在新生儿中应用的具体指南,其安全性和疗效也尚未得到系统评估。本研究旨在介绍我们在新生儿中使用奥曲肽治疗的经验。

方法

这是一项回顾性研究,纳入了在一家三级新生儿中心住院期间接受奥曲肽治疗的新生儿。记录了患儿的人口统计学资料和奥曲肽治疗的适应证,包括治疗开始时间、途径、剂量、持续时间和治疗的不良反应。还分析了奥曲肽给药后的临床病程。

结果

在研究期间,有 11 例新生儿接受了奥曲肽治疗,其中 9 例有乳糜胸,2 例有乳糜性腹水。在 11 例患儿中,有 4 例(36.3%)通过奥曲肽治疗使乳糜性渗出液得到解决。在成功解决问题的患儿中,奥曲肽治疗的中位持续时间为 17.5 天。除了高血糖等轻微副作用外,没有患儿出现需要停止治疗的任何严重副作用。

结论

奥曲肽作为辅助治疗,安全用于治疗新生儿乳糜胸和乳糜性腹水。然而,需要更大规模的前瞻性对照试验来确定奥曲肽在新生儿中的最佳剂量、开始时间、持续时间和疗效。

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