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目的:观察牛肺表面活性剂联合氨溴索治疗早产儿呼吸窘迫综合征(NRDS)的临床疗效。方法:选择2012年1月至2014年12月在陕西省人民医院确诊并接受治疗的NRDS早产儿62例,随机分为对照组32例和观察组30例。两组均给予相同的综合治疗,对照组在综合治疗基础上给予注射用牛肺表面活性剂70~100 mg/kg气管内滴入,观察组给予注射用牛肺表面活性剂(剂量同上)联合静脉滴注氨溴索7.5 mg/kg治疗,比较两组患儿治疗前后的机械通气参数与血气指标的变化,并比较两组患儿机械通气时间、吸入氧浓度(Fi O2)及住院时间。结果:两组治疗前及治疗后血二氧化碳分压(Pa CO2)、氧分压(Pa O2)、血氧饱和度(Sp O2)和p H组内比较差异均有统计学意义(P<0.05);治疗1 h、24 h后两组患儿血Pa CO2、Pa O2、Sp O2和p H比较差异无统计学意义(P>0.05)。治疗后24 h观察组Fi O2低于对照组(P<0.05)。两组患儿上机时间及住院时间比较差异无统计学意义(P>0.05)。观察组撤机后氧疗时间较对照组缩短(P<0.05)。结论:牛肺表面活性剂联合氨溴索治疗早产儿RDS可以尽早降低呼吸治疗中吸入氧浓度及撤机后氧疗时间,从而对早产儿的NRDS治疗起到积极作用。
Objective: To observe the clinical efficacy of bovine pulmonary surfactant plus ambroxol in the treatment of respiratory distress syndrome (NRDS) in preterm infants. Methods: From January 2012 to December 2014, 62 preterm infants with NRDS diagnosed and treated in Shaanxi Provincial People’s Hospital were randomly divided into control group (32 cases) and observation group (30 cases). Both groups were given the same comprehensive treatment, while the control group was given intratracheal instillation of 70 ~ 100 mg / kg bovine pulmonary surfactant on the basis of comprehensive treatment. The observation group was given the combination of bovine pulmonary surfactant (the same dose as above) Intravenous infusion of Ambroxol 7.5 mg / kg treatment, the two groups of children before and after treatment of mechanical ventilation parameters and blood gas changes, and compared the two groups of children mechanical ventilation time, inspired oxygen concentration (Fi O2) and hospital stay. Results: Before treatment and after treatment, PaCO 2, Pa O 2, Sp O 2 and p H in the two groups were significantly different (P <0.05 ). There was no significant difference in PaCO 2, Pa O 2, Sp O 2 and p H between the two groups after treatment for 1 and 24 h (P> 0.05). Fi O2 in observation group 24 hours after treatment was lower than that in control group (P <0.05). There was no significant difference between the two groups in the time of on-boarding and hospital stay (P> 0.05). Oxygen therapy in observation group after weaning shorter than the control group (P <0.05). CONCLUSION: Bovine pulmonary surfactant combined with ambroxol in the treatment of RDS in premature infants can reduce the inhaled oxygen concentration and the oxygen therapy time after weaning as soon as possible, and thus play an active role in NRDS treatment of premature infants.