富血小板血浆与对乙酰氨基酚治疗动脉导管未闭早产儿的疗效与安全性观察  

Effect and safety of PRP and acetaminophen in treatment of premature infants with patent ductus arteriosus

作　　者：梁娟 李丽[2] LIANG Juan;LI li(Department of Pediatrics,Puyang People’s Hospital,Puyang,Henan 457000,China;Anyang Maternal and Chila Health Care Hospital,Anyang,Henan 450000,China)

机构地区：[1]濮阳市人民医院儿科,河南濮阳457000 [2]安阳市妇幼保健院儿内六科,河南安阳450000

出　　处：《医药论坛杂志》2022年第2期54-57,共4页Journal of Medical Forum

摘　　要：目的探讨富血小板血浆(PRP)与对乙酰氨基酚治疗动脉导管未闭早产儿的疗效与安全性。方法选取2018年3月—2020年3月在濮阳市人民医院确诊的90例动脉导管未闭早产儿,采用简单随机分组将患者分为观察组和对照组,每组各45例。对照组患者采用富血小板血浆治疗,观察组采用对乙酰氨基酚治疗,均持续治疗3 d。如果动脉导管未关闭,则立即开始第二疗程,给药方法同第一疗程。比较两组第一疗程和第二疗程结束后的动脉导管关闭率和动脉导管关闭后重新开放率以及两组治疗期间的喂养不耐受、肾功能衰竭、消化道出血、高胆红素血症发生率,平均摄入量和尿量,达到全肠内营养的日龄,住院时间。结果对照组第一疗程结束后动脉导管关闭率和第二疗程结束后的关闭率,动脉导管关闭后重新开放率(77.78%,80.00%,2.22%)和观察组(73.33%,75.56%,4.44%)差异无统计学意义(P>0.05)。两组患者实验室指标水平比较,治疗后血前列腺素E_(2)(PGE_(2))、尿前列腺素E_(2)(PGE_(2))比治疗前显著降低(P<0.05),治疗前后血小板(PLT)水平、谷丙转氨酶(ALT)没有统计学意义(P>0.05)。两组患者治疗期间喂养不耐受、肾功能衰竭、消化道出血、高胆红素血症发生率比较,差异无统计学意义(P>0.05),富血小板血浆(PRP)治疗消化道出血发生率低于对乙酰氨基酚(P<0.05),治疗期间平均摄入量和尿量、达到全肠内营养的日龄、住院时间比较,差异无统计学意义(P>0.05)。结论富血小板血浆(PRP)治疗早产儿动脉导管未闭的疗效和安全性与对乙酰氨基酚相似,富血小板血浆(PRP)治疗期间消化道出血发生率优于对乙酰氨基酚。Objective To explore the effect and safety of platelet-rich plasma(PRP) and acetaminophen in the treatment of premature infants with patent ductus arteriosus(PDA).Methods A total of 90 premature infants confirmed with PDA in the People’s hospital of Puyang were enrolled between March 2018 and March 2020.They were divided into observation group and control group by simple random grouping method,45 cases in each group.The control group was treated with PRP,while observation group was treated with acetaminophen for 3 d.If there was PDA,the second course of treatment was immediately started like the first course.The closed rates of arterial ductus at end of the first and second courses,re-opening rate after arterial ductus closing,incidence of feeding intolerance,renal failure,gastrointestinal bleeding and hyperbilirubinemia during treatment,average intake,urine volume,spending days of total enteral nutrition,and hospitalization time were compared between the two groups.Results The difference in closed rates of arterial ductus at end of the first and second courses,and re-opening rate after arterial ductus closing between control group and observation group was not statistically significant(77.78%,80.00%,2.22% vs 73.33%,75.56%,4.44%)(P>0.05).After treatment,levels of serum prostaglandin E_(2)(PGE_(2)) and urinary PGE_(2) were significantly decreased in both groups(P<0.05).There was no significant significance in levels of platelet(PLT) and alanine aminotransferase(ALT) before and after treatment(P>0.05).The difference in the incidence of feeding intolerance,renal failure,gastrointestinal bleeding and hyperbilirubinemia during treatment between the two groups was not statistically significant(P>0.05).The incidence of gastrointestinal bleeding in patients treated with PRP was lower than that treated with acetaminophen(P<0.05),but there was no difference in the average intake,urine volume,spending days of total enteral nutrition and hospitalization time(P>0.05).Conclusion The effect and safety of PRP and acetaminophen

关 键 词：动脉导管未闭 早产儿 对乙酰氨基酚 PRP 

分 类 号：R722.6[医药卫生—儿科]