双管鼻塞式持续气道正压通气联合盐酸氨溴索在早产儿肺透明膜病中的应用

Application of double tube nasal continuous positive airway pressure ventilation combined with Ambroxol Hydrochloride in treatment of preterm infants with hyaline membrane disease

目的探讨双管鼻塞式持续气道正压通气(CPAP)联合盐酸氨溴索对早产儿肺透明膜病的治疗价值。方法治疗组29例患肺透明膜病的早产儿予双管鼻塞式CPAP呼吸支持并配合静脉推注盐酸氨溴索(20mg.kg-1,每8 h 1次)治疗,对照组27例给予常规机械通气;比较2组患儿的血气变化、并发症、住院时间及费用。结果治疗后6 h、12 h及24 h 2组患儿的血气变化较治疗前显著改善(P<0.05);但2组间比较无明显差异(P>0.05);治疗组肺部感染及慢性肺疾病的发生率明显低于对照组(P<0.05);治疗组的氧疗、住院时间及费用明显少于对照组(P<0.05)。结论带空氧混合器和湿化的双管鼻塞式小儿CPAP联合盐酸氨溴索能有效地治疗早产儿肺透明膜病,具有肺部感染发病率低、慢性肺疾病发生率低、住院时间短、住院费用少等优点。

Objective To explore the therapeutic effects of double tube nasal continuous positive airway pressure （NCPAP） ventilation combined with Ambroxol Hydrochloride in treatment of preterm infant with hyaline membrane disease. Methods Twenty-nine infants with hyaline membrane disease in treatment group were performed with intravenousinfusion with 20 mg·kg^-1 of ambroxol hydrochloride three times daily combined with double tube N-CPAP ventilation, twenty-seven infants in control group were given conventional mechanical ventilation. Changes of blood gas, complications, length of stay and cost of hospitalization were compared between the two groups. Results Blood gases improved at 6 hours,12 hours,24 hours after treatment in the two groups （P 〈 0.05）, but there were no significant difference between two groups. The incidence rate of pulmonary infection and chronic lung disease, oxygen therapy, length of stay and cost of hospitalization were obviously lower in treatment group than those in control group（ P 〈 0.05 ）. Time of oxygen therapy and hospitalization, cost of hospitalization in treatment group were lower than those in control group. Conclusion The double tube N-CPAP ventilation with blender of air-oxygen and humidification combined with ambroxol hydrochloride for treatment of preterm infant with hyaline membrane disease is obviously effective,which have advantages of low incidenceless of pulmonary infection and chronic lung disease, less length of stay and low cost of hospitalization.