布洛芬在肺表面活性物质治疗新生儿呼吸窘迫综合征后的应用研究

摘要

Objective To evaluate the efficacy and safety of prophylactic oral ibuprofen after PS administration of respiratory distress syndrome (RDS) in preterm infants.Methods Total of 51 preterm infants with RDS were treated with PS (Curosurf) and assigned into two groups:23 in preventive group who received prophylactic ibuprofen and 28 without in control group.The duration of assisted ventilation (nasal continuous positive airway pressure and mechanical ventilation),the incidence of patent ductus arteriosus (PDA),pulmonary hemorrhage and mortality rate were analyzed.The adverse effects of ibuprofen and other complications during treatment were recorded.Results No significant differences were found in the duration of assisted ventilation between the two groups [(116.0 ±44.5)h vs.(114.3± 57.7) h,P ＞ 0.05],and neither developed pulmonary hemorrhage nor newborn death in the 2 groups.But significant differences existed between the two group in the incidence of PDA (1/23 vs.14/28,P ＜0.01).Severe side effects (bleeding tendency,NEC,and gastrointestinal perforation)occurred in neither groups.There were no statistically significant differences in the incidence of oliguria,renal impairment,gastrointestinal tract bleeding and feeding intolerance in each group (P ＞ 0.05).Conclusions After treatment of RDS with PS,preventive oral ibuprofen reduced the incidence of PDA,and no significant complications nor side-effects occurred.%目的 探讨在肺表面活性物质治疗新生儿呼吸窘迫综合征(RDS)后,预防性应用布洛芬减少动脉导管未闭(PDA)等合并症的疗效及安全性.方法 选择2011年1月至2013年2月本院新生儿重症监护室收治的RDS早产儿,应用肺表面活性物质治疗后随机分为预防性使用布洛芬组(预防组)和不预防性使用布洛芬组(对照组).比较两组患儿发生PDA比例、辅助通气时间以及肺出血、死亡情况；观察预防性使用布洛芬的不良反应,并进行统计学分析.结果 预防组(23例)和对照组(28例)患儿生后7～10天内超声心动图检测出PDA的例数分别为1例(4.3％)和14例(50％),差异有统计学意义(P＜0.01)；辅助通气时间分别为(116.0±44.5)h和(114.3±57.7)h,差异无统计学意义(P＞0.05)；两组均未出现肺出血和死亡患儿,未出现出血倾向、坏死性小肠结肠炎、胃肠道穿孔破裂等情况.两组少尿、血肌酐＞ 140 μmol/L、上消化道出血或出血加重、喂养不耐受发生率差异均无统计学意义(P＞0.05).结论 在应用肺表面活性物质治疗新生儿RDS后,预防性应用布洛芬可以显著减少PDA发生,安全有效.