具症狀性存開性動脈導管之早產兒以indomethacin藥物治療

Pharmacological Closure of Symptomatic PDA in Premature Infants Using Indomethacin

何文佑(Man-Yan Ho) ； 黃富源(Fu-Yuan Huang) ； 高信安(Hsin-An Kao)

《Acta Paediatrica Sinica》 32卷2期 (1991/04) Pp. 88-94

摘要

早產兒，當經由存開性動脈導管的左至右分流足以影響其心肺功能時，臨床內稱為具症狀性存開性動脈導管。目前被公認的觀念就是一個嬰兒，尤其是正在依賴器械輔助呼吸的早產兒，其具症狀性存開性動脈導管，如不加以治療，將明顯地增加嬰兒的成病率和死亡率，故應以藥物或行外科手術使之關閉。由1984年11月至1987年7月，我們共有22例具症狀性存開性動脈導管之早產兒，接受了經由胃管灌食0.1-0.5mg/dose l-3劑為一治療程之indomethacin治療，成功率為68%。由1987年12月至1989年6月，我們再度選擇了33病例，作為indomethacin療效的評估，為了避免將藥片壓碎的劑量難以計算和沈澱問題，遂將indomethacin溶於酒精，製成0.1mg/ml之溶液，給予0.1-0.3mg/Kg/dose 1-3劑為一治療程，成功率亦僅70%。我們獲得的結果是indomethacin的療效，內服劑不如靜脈注射劑，但在未能取得靜脈注射劑之前，將藥片製成溶液，亦是可用之藥物療法。

並列摘要

When left to right shunting through the ductus arteriosus is of a degree contributing to the cardiopulmonary problems in a premature infant, the condition is clinically termed symptomatic PDA.
It is also generally agreed that symptomatic PDA if left untreated is a significant cause of increased morbidity and mortality. Studies have also concluded that all infants with symptomatic PDA who are prematurely born and/or ventilator dependent should be considered candidates for ductal closure by either pharmaclogical or surgical mean.
Over a period of approximately 2 1/2 years, 22 premature infants with symptomatic PDA have been treated here with powder form indomethacin. The one course success srate was 68%. Thereafter, in another 2 1/2 years, 33 cases were selected for whom a liquid form was used instead. The success rate was 70%.
Indomethacin is better given by an intravenous route. However, if the intravenous form is not available, using the liquid form by mouth or via the naso-gastric tube is a good substitute.

並列關鍵字

symptomatic patent ductus arteriosus ； indomethacin ； premature baby