新生儿肺泡表面活性物质不同给药方法的效果观察

Effects of different methods of medication administration for pulmonary surfactant in newborns

目的探讨新生儿肺泡表面活性物质的最佳给药方式。方法将150例使用肺泡表面活性物质的新生儿分为3组:A组52例,采用三通连接气管插管和复苏气囊,经三通侧孔注入全部药液,同时使用复苏气囊正压通气;B组48例,用注射器连接去掉针头的头皮针软管,将软管插入气管插管头端,分次注入药物后抽出软管,再用复苏气囊连接气管插管行正压通气1～2min后,反复数次滴完全部药液;C组50例,采用常用方法,即用注射器针头插入气管插管,在患儿3种不同体位时分次滴入药液的1/3量,每种体位滴完后均用复苏气囊正压通气1～2min。观察3组患儿用药前后的经皮血氧饱和度(SpO_2)、药物反流情况和给药时间。结果 A组用药前后SpO_2没有明显变化,没有出现药物反流,给药时间短。与其他两组比较,差异有统计学意义(P<0.01)。结论三通连接气管插管和复苏气囊,经三通侧孔注入肺表面活性物质给药不良反应少,不会造成药物浪费,操作简单,值得推广。

Objective To find an optimal medication administration method for pulmonary surfactant in newborns. Methods Totally 150 neonates received pulmonary surfaetant were divided into three groups. In group A,the pulmonary surfactant was instilled through the side hole of a three-way stopcock linked with the tracheal tube and a gas bag,and the neonates received positive pressure ventilation when the pulmonary sudactant was instilled. In group B,the pulmonary suffactant was instilled by times through a syringe linked with a scalp needle,which was inserted into the tracheal tube,and the neonates received posi- tive pressure ventilation for two minutes after medication administration. In group C ,the pulmonary surfactant was instilled three times in different body positions by a syringe directly inserted into the tracheal tubo,and the neonates received positive pressure ventilation for two minutes after each time of medication administration. The oxygen saturation（SpOz） before and after medication administration,incidence to drug reflux and duration of medication administration were recorded. Results In group A,no drug reflux occurred, the level of SpO2 was more stable and the duration of medication administration was shorter than group B and group C（P〈0.01）. Conclusion Instilling pulmonary surfactant through the side hole of a three-way stopcock linked with the tracheal tube and a gas bag can bring less adverse drug effect and reduce medicine waste.