JAMA:布洛芬是早产儿动脉导管未闭更佳的保守治疗方案

2018-03-28 zhangfan MedSci原创

研究认为口服高剂量布洛芬是早产儿动脉导管未闭最佳的保守治疗方案

对于早产儿动脉导管未闭(PDA)的保守治疗越来越受到重视,近日研究人员比较了不同药物对具有血流动力学意义的PDA封堵效果及不良事件的差异。

研究人员对2015-17年间MEDLINE, Embase以及 the Cochrane Central Register of Controlled Trials数据库的相关研究进行检索。胎龄小于37周、临床或超声心动图显著性PDA早产儿,采用静脉注射或口服吲哚美辛、布洛芬或对乙酰氨基酚治疗的随机对照试验纳入本次分析,采用贝叶斯随机效应网络综合分析研究数据,主要终点包括血流动力学意义上的PDA闭合;次要终点包括闭合手术、死亡率、坏死性小肠结肠炎和脑室内出血。

68个随机研究,总计4802名患儿纳入本次研究,总计14种不同形式的吲哚美辛、布洛芬或对乙酰氨基酚组合作为治疗手段。总的PDA闭合率为67.4% (2867/4256)。口服高剂量布洛芬,相比于标准剂量布洛芬静脉注射 (OR, 3.59; 95% CrI, 1.64-8.17;每1000患儿绝对风险差异199 [95% CrI, 95-258])和标准剂量吲哚美辛注射(OR, 2.35 [95% CrI, 1.08-5.31]; 每1000患儿风险差异124 [95% CrI, 14-188])可显著提高闭合率。依据排名统计,高剂量口服布洛芬是最佳的PDA药物治疗选择(SUCRA,0.89) ,可有效避免PDA手术率(SUCRA, 0.98)。

研究认为口服高剂量布洛芬是早产儿动脉导管未闭最佳的保守治疗方案。

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    2018-04-04 考拉2177

    真好的app

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    2018-03-29 owlhealth

    不错耶.学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1905047, encodeId=4b40190504ea9, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Fri Apr 20 21:28:00 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302757, encodeId=fcd4302e5725, content=真好的app, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/03/31/d7203757d74b0bd09c77c59b954b84a2.jpg, createdBy=29eb2235500, createdName=考拉2177, createdTime=Wed Apr 04 20:43:26 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508910, encodeId=ca39150891090, content=<a href='/topic/show?id=8e1e2e181f4' target=_blank style='color:#2F92EE;'>#保守治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27181, encryptionId=8e1e2e181f4, topicName=保守治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9d710016703, createdName=cmsvly, createdTime=Fri Mar 30 04:28:00 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1522275, encodeId=89e015222e59f, content=<a href='/topic/show?id=ed183323e02' target=_blank style='color:#2F92EE;'>#动脉导管未闭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33237, encryptionId=ed183323e02, topicName=动脉导管未闭)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=40e811444670, createdName=shizhenshan, createdTime=Fri Mar 30 04:28:00 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=300761, encodeId=3b82300e6134, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Thu Mar 29 07:11:27 CST 2018, time=2018-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=300514, encodeId=e10d30051438, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Wed Mar 28 13:30:39 CST 2018, time=2018-03-28, status=1, ipAttribution=)]
    2018-03-28 惠映实验室

    学习了.谢谢分享.

    0

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