【摘要】 目的评价对乙酰氨基酚(APAP)治疗早产儿动脉导管未闭(PDA)的疗效及安全性。方法检索中国期刊全文数据库、万方数据库、维普中文科技期刊数据库及PubMed、Ovid、Medline、Cochrane数据库,收集关于APAP治疗早产儿PDA的随机对照试验,干预组采用APAP治疗,对照组采用布洛芬治疗。检索时间均从建库至2019年8月1日。采用Rev Man5.3软件进行meta分析,同时对各项研究发表偏倚进行分析。结果共纳入10篇文献,各项研究存在发表偏倚的可能性小。干预组少尿、消化道出血、高胆红素血症发生率均低于对照组,差异均有统计学意义(P<0.05)。两组在动脉导管闭合率、病死率、不良反应(坏死性小肠结肠炎、脑室内出血、肾功能不全、支气管肺发育不良、败血症、早产儿视网膜病)发生率及血肌酐、血小板、谷丙转氨酶水平方面比较,差异均无统计学意义(P>0.05)。结论 APAP治疗早产儿PDA的疗效肯定且用药安全,值得临床推广应用。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of paracetamol(APAP)in the treatment of patent ductus arteriosus(PDA)in premature infants.Methods The randomized controlled trials of APAP in the treatment of PDA in premature infants were collected by searching the full-text database of Chinese journals,Wanfang database,VIP database of Chinese science and technology journals,PubMed,Ovid,Medline,Cochrane databases.APAP was used in the intervention group and Ibuprofen in the control group.The retrieval time was from the establishment of the database to August 1,2019.The Rev Man5.3 software was used to conduct the meta analysis,and the publication bias of various studies were analysed.Results 10 articles were included,and the possibility of publication bias of various studies were small.The incidence of oliguria,gastrointestinal hemorrhage and hyperbilirubinemia in the intervention group was lower than those in the control group,the differences were statistically significant(P<0.05).There were no significant differences between the two groups in the closure rate of ductus arteriosus,fatality rate mortality,incidence of adverse reactions(necrotizing enterocolitis,intraventricular hemorrhage,renal insufficiency,bronchopulmonary dysplasia,septicemia,retinopathy of prematurity)and the levels of serum creatinine,PLT and ALT(P>0.05).Conclusion APAP is effective and safe in the treatment of PDA of premature infants,which is worthy of clinical application.更多还原