大剂量盐酸氨溴索配合持续气道正压治疗新生儿呼吸窘迫综合征的临床观察

Clinical effect of large-dose ambroxol hydrochloride combined with nasal continuous positive airway pressure on treatment of neonatal respiratory distress syndrome

目的观察在应用鼻塞持续气道正压通气(NCPAP)等综合治疗的基础上,使用大剂量盐酸氨溴索治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法 64例NRDS患儿随机分成治疗组和对照组各32例,两组在应用NCPAP等综合治疗的基础上,治疗组给予大剂量盐酸氨溴索30mg/(kg·d),分4次加入10%葡萄糖注射液10ml中稀释后,用微量输液泵静脉滴注,滴注时间>10分钟,每6小时1次,连用3天。观察两组患儿治疗前后的血气指标、NCPAP参数变化、氧合指数(OI)、给氧时间、X线胸片、并发症及住院时间。结果治疗组应用大剂量盐酸氨溴索24小时后,呼吸频率、X线胸片、NCPAP参数变化、OI、给氧时间及住院时间与对照组比较有明显改善,差异均有统计学意义(P<0.05)。结论大剂量盐酸氨溴索配合NCPAP治疗NRDS能快速改善肺顺应性,减少机械通气使用率,缩短给氧时间和住院时间。

Objective To observe the efficacy of large-dose ambroxol hydrochloride and nasal continuous positive airway pressure（NCPAP）in treatment of neonatal respiratory distress syndrome（NRDS）.Methods 64 eases of neonates with neonatal respiratory distress syndrome were randomly divided into a treatment group and a control group with 32 patients in each group.Both groups were given NCPAP.Additionally,the treatment group were given large-dose ambroxol hydrochloride 30mg/（kg · d）,divided into four times ＋ 10％ GS 10 ml by transfusion pump every 6 hours,for three days.The indexes of blood gas analysis,NCPAP machine parameters,OI,length of oxygen therapy,chest X-ray,complication,length of hospital stay of the two groups were observed before and after treatment.Results 24 hours after using ambroxol hydrochloride,the respiratory rate,chest X-ray,NCPAP machine parameters,OI and the length of oxygen and hospitalization in treatment group improved more significantly than those in control group （P＜0.05）.Conclusion Large-dose ambroxol hydrochloride combined with NCPAP in the treatment of NRDS can quickly improve pulmonary compliance,and reduce the need of mechanical ventilation and the length of oxygen and hospitalization.