静脉注射和口服吲哚美辛治疗早产儿动脉导管未闭疗效比较

目的　探讨静脉注射和口服吲哚美辛治疗早产儿动脉导管未闭 (PDA)的疗效。方法　经心脏彩超确诊的有症状PDA早产儿 4 9例 ,按给药剂型及途径分为静注组 (2 1例 )和口服组 (2 8例 )。剂量及给药间隔时间相同。比较两组PDA关闭率和不良反应。结果　两组单纯PDA闭合、并其他疾病PDA闭合均无显著差异。静注组立即闭合率明显高于口服组 (P <0 .0 5 )。两组较快闭合、迟缓闭合和总闭合虽有差别 ,但无统计学意义。静注组胃肠出血、肾功能减低及高胆红素血症与口服组比较均无显著差异。静注组不良反应总人次明显低于口服组 (P <0 .0 5 )。结论　一定剂量范围内静脉注射或口服吲哚美辛治疗早产儿PDA均具一定有效性和安全性 ,但口服给药不良反应相对较多

Comparison of intravenous and oral indomethacin for treating preterm infants with patent ductus arteriosus

Objective To compare efficacy and side effects of intravenous versus oral indomethacin treatment for symptomatic patent ductus arteriosus (PDA) in preterm infants.Methods Fourty-nine preterm infants were reviewed retrospectively who were diagnosed as having symptomatic PDA confirmed by echocardiography.According to the using type and approach that were divided into 2 groups (intravenous group,n=21;oral group,n=28) and their doses and intervals were same.The rates of ductal closure and side effects were compared in 2 groups.Results There were no significantly different between 2 groups in single ductal closure and complicating other diseases. Soon closure of intravenous group was higher significantly than oral group 61.9 %(13/21) vs 28.6 %(8/28),P<0.05]. There were some difference on fast closure, slow closure and total closure, but there were no statistically significant difference. More cases of gastrointestinal bleeding, renal disfunction and jaundice were seen in oral group The total side effects rate of intravenous group was significantly lower than that of oral group 14.3 % (3/21) vs 46.4 % (13/28),P<0.05].Conclusions On some range of doses, indomethacin by intravenous and oral treatment are more safe and effective correspondingly for symptomatic PDA in preterm infants. There are more side effects in oral group than intravenous group.