[摘要]目的: 观察预防性口服布洛芬关闭极低体重儿动脉导管未闭(PDA)的疗效及安全性。 方法: 将74例极低体重儿随机分成预防组32例，生后6h内予以口服布洛芬悬液;另42例作为对照组不予布洛芬口服，如临床出现PDA征象和.或心脏彩超证实有PDA存在，再予以布洛芬治疗。两组患儿7～10d后心脏彩超检查观察PDA关闭率，并观察布洛芬的不良反应及并发症。 结果: 预防组PDA关闭率为90.62%，对照组为78.57%，对照组中9例有PDA者经布洛芬治疗后5例关闭，最终PDA关闭率达90.47%，两组比较差异无统计学意义;预防组17例(53.13%)在首剂后即出现少尿，2例因出现无尿而停药，对照组6例(14.28%)出现少尿，差异有统计学意义(P<0.05);入院时血肌酐(Cr)预防组(71.67±9.24)μmol.L，对照组(73.26±9.53)μmol.L，差异无统计学意义(P>0.05);第4d血肌酐预防组(89.02±21.86)μmol.L，对照组(69.12±11.35)μmol.L，差异有统计学意义(P<0.05);两组坏死性小肠结肠炎(NEC)、胃出血发病率无统计学意义，但预防组喂养不耐受(FI)发病率高，达全胃肠道喂养时间(FEF)长，差异有统计学意义(P<0.05);两组脑室内出血(IVH)、慢性肺部疾病(CLD)、病死率、血小板比较差异无统计学意义。 结论: 极低体重儿7～10d PDA自然关闭率高，布洛芬早期用药增加了极低体重儿脏器损伤的风险，临床出现PDA后再予以布洛芬治疗可能更合理、更安全。

    [关键词] 极低体重儿;动脉导管未闭;布洛芬;预防

    The clinical study of preventive oral ibuprofen to patent ductus arteriosus in very low birth weight infant

    ZHANG Ling-ling

    1 ，WANG Jian-hong

    1 ，YANG Xiao-hong

    2 ，et al (1.The Third People's Hospital ofWenzhou，Zhejiang Wenzhou 325000，China;2.The People's Hospital of Lishui，Zhejiang Province，Zhejiang Lishui 323000，China)

    [Abstract] Objective:To study the clinical effect and safety of preventive oral ibuprofen on patent ductus arteriosus in very low birth weight in-fant.Methods:74cases were divided into a preventive group of32cases with oral ibuprofen and a control group of42cases without oral ibuprofen unless the symptoms of patent ductus arteriosus appeared and.or were detected by the color doppler.Results:The closing rate in the prevention group was90.62% ......