沐舒坦不同给药方式治疗肺透明膜病的研究

A study on different administration ways of mucosolvan for treatment of hyaline membrane disease in premature infants

目的探讨沐舒坦不同给药方式对早产儿肺透明膜病的治疗作用。方法将101例肺透明膜病早产儿分为4组：静脉组29例，经静脉给予沐舒坦7．5mg·kg^-1·次^-1，每6小时1次，疗程为3～5天；雾化组29例，经口鼻超声雾化吸入沐舒坦7．5mg·kg^-1·次^-1，每6小时1次，疗程为3～5天；气管内给药组15例气管插管气管内滴入沐舒坦7．5mg·kg^-1·次^-1，每6小时1次，后用气囊正压通气5分钟至肺部吸收，疗程为3～5天；对照组28例给予一般综合治疗，观察治愈率及并发症的发生差异。结果静脉组、雾化组、气管内给药组与对照组比较，3组均可降低早产肺透明膜病患儿死亡率（X2=9．02，P〈0．05），还可降低部分并发症（肺炎、肺出血、支气管肺发育不良、坏死性小肠结肠炎）的发生率，改善早产肺透明膜病患儿的预后，但3种不同给药方式之间治愈率及并发症发生率比较无显著性差异（P〉0．05）。结论出生后3小时内静推、超声雾化吸入、气管插管气管内滴入沐舒坦均可较好地治疗早产儿肺透明膜病，同时减少部分并发症的发生。

Objective To investigate therapeutic effects of different administration ways of mucosolvan for hyaline membrane disease （HMD）in premature infants. Methods 101 premature infants with HMD were divided into 4 groups： 29 premature infants were given 7.5mg · kg^-1 ·time^-1 of mucosolvan by intravenous infusion, once per 6 hours for 3 -5 days as intravenous infusion group; other 29 premature infants were given 7.5mg · kg^-1 ·time^-1 of mucosolvan by ultrasonic aerosol inhalation through nose and mouth, once per 6 hours for 3 - 5 days as aerosol inhalation group; 15 premature infants were given 7.5mg · kg^-1 ·time^-1 of mucosolvan by tracheal intubation tracheal instillation, once per 6 hours after positive pressure ventilation with air bag for 5 minutes for 3 ~ 5 days as intratracheal instillation group; 28 premature infants were given general comprehensive treatment as control group. The curative rate and the incidences of complications of infants in the two groups were observed and compared. Results The mortality rate in the intravenous infusion group, aerosol inhalation group and intratracheal instillation group was significantly lower than that in the control group, there was a significant difference （X2 = 9. 02, P 〈 0.05 ）. And the incidence rates of some complications such as pneumonia, pulmonary hemorrhage, bronchopulmonary dysplasia, necrotizing enterocohtis in three administration groups were lowered and prognosis of the disease was improved. However, in curative rate and incidence rates of some complications between the three different administration ways groups, there was no significant difference （ all P 〉 0. 05 ）. Conclusion Intravenous infusion, ultrasonic atomizing inhalation, intratracheal instillation under tracheal incubation of mucosolvan within 3 hours after birth can treat respiratory distress syndrome （RDS） caused by HMD of premature infants effectively and reduce incidences of some complications.