β_2-受体激动剂治疗新生儿暂时性呼吸急促

Inhaled Beta-2 Agonist Salbutamol for the Treatment of Transient Tachypnea of the Newborn

目的探讨吸入β2-受体激动剂(舒喘灵)治疗新生儿暂时性呼吸急促(transient Tachypnea of the Newborn TTN)的疗效,并确定新生儿吸入舒喘灵的安全性.方法将2011年10月至2014年6月入住昆明市妇幼保健院的100例TTN患儿随机分为吸入舒喘灵组(治疗组)52人,未吸入组(对照组)48人,胎龄37周至40+3周.治疗组通过舒喘灵喷雾瓶、储雾罩在入院60 min、6 h分别给予0.4 mg舒喘灵气雾剂吸入;对照组按常规治疗.结果 (1)2组患儿在入院后7、12、24 h呼吸急促、呻吟、吸凹征严重程度比较,治疗组较对照组明显减轻和持续时间明显缩短,差异有统计学意义(P<0.05);(2)治疗组用药前后心率无明显增加,2组心率统计学处理,差异无统计学意义(P>0.05);(3)舒喘灵组需要常压给氧、n CPAP治疗时间较对照组缩短,差异有统计学意义(P<0.05);(4)机械通气治疗:舒喘灵组1例(1.9%)、对照组6例(12.5%),差异有统计学意义(P<0.05);(5)2组入院后12 h监测平均p H值、氧分压、二氧化碳分压转归情况比较,差异有统计学意义(P<0.05);(6)在研究过程中,心电监护无1例心律失常发生;52例治疗组患儿均未出现肌肉震颤症状.结论吸入舒喘灵对新生儿暂时性呼吸急促治疗有明显疗效.且临床和实验室检查均未发现不良反应.

Objective To evaluate the efficacy of inhaled salbutamol, a beta- 2 adrenergic agonist, for the treatment of transient tachypnea of the newborn（TTN） and to determine whether inhaled salbutamol is safe in newborn infants. Methods From October 2011 through June 2014, we conducted a retrospective study of 100 newborns with gestational ages ranging from 37 weeks to 40 weeks and 3 days hospitalized with TTN in the neonatal intensive care unit. Patients were given either salbutamol（52 patients） or nothing（48 patients）. The salbutamol nebulization therapy was given at 60 minutes and 6 hours after hospitalized and clinical indices were compared.Results Among the 100 infants with TTN, 52 received salbutamol and 48 received routine treatment. After treatment the salbutamol group showed significant improvements in respiratory rate, clinical signs of TTN at 7,12, 24 hours,fraction of inspired oxygen,and level of respiratory support（CPAP or mechanical ventilation）（P〈0.05）. After treatment, the mean p H,partial pressure of arterial oxygen,and partial pressure of arterial carbon dioxide values were better in the salbutamol group when compared with the control group（P〈0.05） at 12 hours after hospitalized. Duration of hospitalization in the neonatal intensive care unit was also shorter for the salbutamol group（P〈0.05）. The difference of heart rate in two groups was not statistically significant（P〈0.05）. No infant in either the treatment or control arm experienced an adverse event, including arrhythmia or muscle tremors.Conclusion Inhaled salbutamol treatment is effective with respect to both clinical and laboratory findings of TTN and without adverse events.