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目的探讨大剂量沐舒坦经不同方式给药,对早产儿肺透明膜病(HMD)的防治作用。方法将我院产科出生、生后立即转入新生儿病房的早产儿随机分为静脉+雾化组、单纯静脉组(两用药组)及对照组(未用沐舒坦)。所有患儿均综合治疗,在此基础上两用药组入院后立即(生后1 h内)给予沐舒坦治疗,其中静脉+雾化组予以沐舒坦:15 mg/(kg.d),分2次,用5%葡萄糖5 ml稀释后,使用注射器泵10 min泵入,另外15 mg/(kg.d),分2次,氧气驱动雾化吸入,用药2~3 d;单纯静脉组予以沐舒坦:30 mg/(kg.d),分4次,用5%葡萄糖5 m l稀释后,使用注射器泵10 min泵入,用药2~3 d。观察三组HMD发生率及病死率,比较入院24 h血气分析结果,注意沐舒坦不良反应。结果HMD发生率两用药组显著低于对照组(P<0.01,P<0.05),静脉+雾化组病死率较对照组显著降低(P<0.05),血pH值、PaO2、PaCO2三方面两用药组与对照组比较差异均有统计学意义(P<0.01,P<0.05),未发现沐舒坦不良反应。结论早产儿生后早期应用大剂量沐舒坦防治HMD,疗效确切且安全可靠,静脉注射+氧气驱动雾化吸入方式给药较单纯静脉注射效果更好。
Objective To investigate the preventive and therapeutic effects of high-dose ambroxol on different modalities of hyaline membrane disease (HMD) in preterm infants. Methods The premature infants who were born in obstetrics and gynecology department of our hospital and transferred to neonatal ward immediately after birth were randomly divided into intravenous + atomizing group, simple intravenous group (control group) and control group (not using mucosolvin). All patients were treated comprehensively. On the basis of this, the two groups were given mucosolvan immediately after admission (within 1 h after birth), and the patients in the intravenous + atomized group were treated with mucosolvan 15 mg / (kg.d) Times, diluted with 5 ml of 5% dextrose and then pumped with a syringe pump for 10 min, another 15 mg / (kg.d), divided into 2 times and inhaled with oxygen for 2 to 3 days. Sutan: 30 mg / (kg · d), divided 4 times, diluted with 5 ml of 5% glucose, the use of syringe pump 10 min, medication 2 ~ 3 d. The morbidity and mortality of HMD in the three groups were observed. The blood gas analysis results at 24 h after admission were compared, and mucosolvan adverse reactions were observed. Results The incidence of HMD was significantly lower in the two groups than that in the control group (P <0.01, P <0.05). The morbidity of HMD was significantly lower in the two groups than in the control group (P <0.05) There was significant difference between the treatment group and the control group (P <0.01, P <0.05), and no adverse effects of mucosolide were found. Conclusions The high dose of ambroxol used in the prevention and treatment of HMD in the early postnatal period is safe and reliable. The effect of intravenous injection + oxygen driven atomization inhalation is better than intravenous injection alone.