大剂量盐酸氨溴索预防及辅助治疗极低出生体重儿呼吸窘迫综合征效果观察

Effective observation on high-dose ambroxol in prevention and adjuvant therapy for respiratory distress syndrome in very low birth weight

目的观察早期应用大剂量盐酸氨溴索(沐舒坦)对极低出生体重儿呼吸窘迫综合征(NRDS)的防治效果。方法对出生体质量<1 500 g的早产儿54例,随机分为治疗组28例及对照组26例。治疗组除按常规处理外于生后6 h内应用沐舒坦每次7.5 mg/kg,每6小时1次静脉滴注,对照组按常规处理。两组同时严密观察72 h。对出现经皮血氧饱和度进行性下降及呼吸频率增快、呻吟等情况即摄胸片,如证实为呼吸窘迫综合征,立即开始鼻导管CPAP治疗。结果NRDS的发生率治疗组为21.4%,对照组为50%,治疗组低于对照组(P<0.05);治愈率治疗组为92.9%,对照组69.2%,治疗组高于对照组(P<0.05)。结论大剂量盐酸氨溴索可减少极低出生体重早产儿RDS的发生。对已经发生RDS者,联合应用CPAP可降低其死亡率。

Objective To investigate the preventive and therapeutic effect of early use of high -dose ambroxol hydrochloride （trade names Mucosolvan, Boehringer Ingelheim company） for respiratory distress syndrome （RDS） in very low birth weight newborns. Methods Fifty-four very low birth weight newborns of birth weight 〈 1 500 grams, were randomly divided into the treatment group （28 cases） and the control group（26 cases）. The treatment group was given ambroxol hydrochloride 7. 5 mg / kg, per 6 hours,intravenous drip in 6 hours after birth. The 26 cases of the contral group were used as clinical control. At the same time, the close observation was performed in the two groups for 72 hours. When the progressive decline of percutaneous oxygen saturation, faster respiratory rate, groaning, etc. Occurred during observation period, the newborns should be examined by chest X-ray. Once as RDS were diagnosed, the nasal CPAP treatment immediately was used. Results The incidence of RDS in the treatment group was 21.4%, the incidence of NRDS in the control group was 50%, the difference between two groups was significant （P 〈0. 05）. The cure rate of the treatment group was 92. 9%, that of the control group was 69.2%, the difference between two groups was significant （ P 〈 0. 05 ）. Conclusion High-dose ainbrexol hydrochloride can reduce the incidence of RDS in the very low birth weight premature newborns. When RDS happened, the joint applica- tion of CPAP can reduce its mortality.