吲哚美辛在新生儿呼吸窘迫综合征预防和治疗中的应用  

Effect of indomethacin on complications of preterm neonatal respiratory distress syndrome after pulmonary surfactant treatment or prevention

作　　者：鲁珊[1] 王新利[1] 刘虹[1] 朴梅花[1] 童笑梅[1] 叶鸿瑁[1] 

机构地区：[1]北京大学第三医院儿科,100083

出　　处：《中华围产医学杂志》2005年第2期101-106,共6页Chinese Journal of Perinatal Medicine

摘　　要：目的　探讨预防性应用吲哚美辛减少肺表面活性物质治疗或预防新生儿呼吸窘迫综合征的合并症。　方法　临床诊断为新生儿呼吸窘迫综合征的早产儿 40 例,用肺表面活性物质(固尔苏)治疗,按有无用吲哚美辛预防分为A1 组22例与B1 组18例。胎龄< 32 周未发生新生儿呼吸窘迫综合征的早产儿 37 例,用肺表面活性物质预防,按有无用吲哚美辛预防分为 A2 组 24 例与 B2 组13例。分别比较A1 与B1 组、A2 与B2 组的辅助通气(含鼻塞CPAP和机械通气)时间和发生动脉导管未闭、肺出血、脑室内出血及死亡情况分布并做统计学分析。　结果　A1 与B1 两组辅助通气时间分别为 (94.9 ± 61.5) h、(105.8 ± 103.0) h,差异无统计学意义(P>0.05);发生动脉导管未闭例数分别为8、14例,差异有统计学意义(P<0.05);发生肺出血、脑室内出血例数的差异无统计学意义(P>0.05);死亡例数≤3 d分别为0和3例,差异有统计学意义(P<0.05),>3 d各为 3 例,差异无统计学意义(P>0.05)。A2 与B2 两组辅助通气时间分别为 (24.0 ± 20.8) h、(44.0± 25.9) h,发生动脉导管未闭例数分别为2和5例,差异均有统计学意义(P<0.05);发生肺出血例数的差异无统计学意义(P>0.05);发生脑室内出血例数较少,死亡例数≤3 d分别为0和1 例,>3 d各为 1 例,未做统计学分析。Objective To evaluate the effect of indomethacin prophylaxis on the complications of neonatal respiratory distress syndrome(NRDS)after pulmonary surfactant(PS) treatment or prevention in preterm infants. Methods Forty preterm infants with NRDS were treated with PS (Curosurf) and assigned to two groups: 22 in group A 1 received prophylactic indomethacin and 18 in group B 1 did not. Another 37 preterm infants who were born less than 32 weeks without NRDS received PS for prevention and were assigned to two groups: 24 in group A 2 received prophylactic indomethacin and 13 in group B 2 did not. The duration of assistant ventilation time (nasal continuous positive airway pressure and mechanical ventilation), the frequency of patent ductus arteriosus(PDA), pulmonary hemorrhage, intraventricular hemorrhage and mortality rate were analyzed. Results Between group A 1 and B 1, no significant differences was found in the duration of assistant ventilation time [(94.9 ± 61.5) h vs (105.8 ± 103.0)h,P>0.05)], the number of cases of pulmonary and intracranial hemorrhage (P>0.05) and newborn death >3 d (3 vs 3, P>0.05). But significant difference was shown between these two groups in the case number of PDA (8 vs 14, P<0.05) and newborn death ≤3 d (0 vs 3, P<0.05). When comparing group A 1 with B 1, the assistant ventilation time were (24.0 ± 20.8)h and (44.0 ± 25.9)h, respectively, and the number of PDA were 2 and 5 cases (P<0.05); the number of cases in pulmonary hemorrhage were 1 and 3 (P>0.05). Few neonates developed intraventricular hemorrhage. In these two groups, the number of dead neonates ≤3 d were 0 and 1 and for those (>3 d) was only 1 in each. Conclusions In prevention or treatment of NRDS with PS,prophylactive indome-(thacin) reduces the rate of PDA,pulmonary hemorrhage and early death in preterm infants.

关 键 词：新生儿呼吸窘迫综合征 吲哚美辛 预防和治疗 肺表面活性物质 动脉导管未闭 脑室内出血 统计学分析 鼻塞CPAP 辅助通气 预防性应用 肺出血 临床诊断 机械通气 死亡情况 早期死亡 早产儿 死亡例 合并症 固尔苏 时间 

分 类 号：R722.1[医药卫生—儿科]