目的：開放性動脈導管是非常早產新生兒常見的問題，也是有呼吸窘迫症且正使用呼吸器新生兒之常見併發症。本研究目的為探討華人出生時有無呼吸窘迫症與之後發生開放性動脈導管需用indomethacin 治療的相關性。
方法：於2008 年1 月1 日至2009 年12 月31 日止，兩年間共有658 名新生兒住進我們的新生兒加護病房而納入此研究。他們的母親懷孕週數是23 至42 週 (34.0±3.9 週)。出生體重，母親懷孕週數，有無呼吸窘迫症及有無使用indomethacin 均有被記載。
結果：此658 名納入研究的新生兒有33 個(5.02%)接受indomethacin 治療。其中，88 名有呼吸窘迫症新生兒中有9 名(10.23%)之後接受indomethacin 治療，570 名沒有呼吸窘迫症新生兒中有24 名(4.21%)之後接受indomethacin 治療。新生兒出生時有呼吸窘迫症似乎之後有較高機率會發展出開放性動脈導管而使用indomethacin。然而，就母親懷孕週數小於(等於)34 週的這組350 名早產兒當中，83 名有呼吸窘迫症新生兒中有8 名(9.64%)之後接受indomethacin 治療，267 名沒有呼吸窘迫症新生兒中有24 名(8.99%)之後接受indomethacin治療，並沒有統計上有意義的差異性(p=0.858)。
結論：在母親懷孕週數小於(等於)34 週的這些早產兒，出生時有無呼吸窘迫症與之後發展出開放性動脈導管而使用indomethacin 治療並無相關性，意指預防性indomethacin 來避免開放性動脈導管於有呼吸窘迫症的早產兒在其出生後24 小時內使用應該是不需要的。
Object:Patent ductus arteriosus (PDA) is a common problem in very premature neonates, and also is a common complication in neonates ventilated for respiratory distress syndrome (RDS). The goal of this study was to explore the association between Chinese neonates born with or without RDS and PDA with indomethacin therapy thereafter.
Methods:In total 658 neonates admitted to our neonatal intensive care unit (NICU) from Jan. 1, 2008 through Dec. 31, 2009 had been enrolled in this study. The gestational age (GA) ranged from 23 to 42 weeks (34.0±3.9 weeks). Birth weight, gestational age, RDS or not, and indomethacin use or not were all recorded.
Results:Thirty-three (5.02%) of 658 included neonates received indomethacin. Nine (10.23%) of the 88 neonates with RDS received indomethacin, and 24 (4.21%) of the 570 neonates without RDS received indomethacin thereafter. Neonates born with RDS seemed to have higher probability of developing PDA, which prompts the use of indomethacin. However, in the group of 350 prematures with GA≦34 weeks,8 (9.64%) of the 83 neonates with RDS received indomethacin, and 24 (8.99%) of the 267 neonates without RDS received indomethacin thereafter. The difference ( p=0.858 ) was not significant.
Conclusion:There was no association between RDS and PDA with indomethacin therapy thereafter in the prematurity with GA≦ 34 weeks, meaning that prophylactic indomethacin therapy in the first twenty-four hours of life for the prevention of PDA in preterm infants with RDS is probably not necessary.
