一次性硬膜外导管在新生儿气管内注入肺表面活性物质中的应用

Application of Disposable Hard Covering External Catheter in Introtracheal Infusion of Pulmonary Surfactant for Newborns

目的探讨一次性硬膜外导管在新生儿气管内注入肺表面活性物质(pulmonary surfactant,PS)中的应用效果。方法选择2006年4月—2007年4月应用PS治疗新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)患儿26例作为对照组,采用细硅胶吸痰管经气管内推注PS;选择2007年5月—2008年5月应用PS治疗NRDS患儿34例作为观察组,采用有刻度的一次性硬膜外导管经气管内推注PS。观察比较两组插管时间、用药总过程时间、用药后不良反应及用药前后血气分析值。结果(1)观察组插管时间、用药总过程时间短于对照组,药物残留少于对照组,差异均有统计学意义(P<0.001);(2)观察组用药后面色发绀、口吐泡沫、经皮血氧饱和度下降至85%以下例数少于对照组,差异均有统计学意义;(3)在应用PS后0.5h和6h血气分析结果比较,观察组血pH值改善明显,血PaO2提升快,PaCO2下降快,差异具有统计学意义。结论利用一次性硬膜外导管推注PS可明显缩短插管时间及用药时间,减少药液残留与反流;可有效减少推药过程中人为造成的缺氧状态。

Objective To explore the effect of the application of disposable hard coveting external catheter in introtracheal infusion of pulmonary surfactant（PS） for newborns. Methods The control group, made of 26 children patients who received the treatment of neonatal respiratory distress syndrome （NRDS） with PS between April, 2006 and April, 2007, were offered tracheal bolus injection of PS by means of tiny gel silica sputum drawing tube; the observation group, made of 34, however, were offered tracheal bolus injection of PS through disposable hard coveting external catheter. Then a comparison was made of the time the intubations and medicine administration took, the adverse reactions after the administration and the blood gas analysis values. Results The intubation time, medicine administration time and the medicine residue of the observation group were less than those of the control group, with the differences being statistically significant （P〈0.001）. The number of cases with facial cyanosis, foam at the mouth and lower than 85% percutaneous blood oxygen saturation was smaller than that of the control group, all the differences with statistical significance. And it was revealed by the comparison of the blood gas analysis results that compared with the control group, the blood pH improved more markedly, the blood Pa02 increased and PaC02 decreased with greater rapidity, with the differences having statistical significance. Conclusion The improved bolus injection through the catheter can markedly reduce the time the intubation and drug administration take, the drug residue and back flow, and thus the incidence of oxygen lack in the injection.