盐酸氨溴索联合牛肺表面活性物质治疗早产儿呼吸窘迫综合征的临床疗效观察

Clinical effect of ambroxol hydrochloride combined with bovine pulmonary surfactant on treatment of premature neonates with respiratory distress syndrome

目的探讨盐酸氨溴索联合牛肺表面活性物质治疗早产儿呼吸窘迫综合征的临床效果。方法 50例呼吸窘迫综合征患儿分为单独应用注射用牛肺表面活性物质组(对照组)以及盐酸氨溴索联合注射用牛肺表面活性物质组(观察组)。比较2组患儿在治疗后1、12、24、48 h的氧分压[p(O_2)],二氧化碳分压[p(CO_2)]以及计算氧合指数[p(O_2)/FiO_2];比较2组患儿呼吸机治疗时间、撤离呼吸机后的氧疗时间以及住院时间。结果观察组治疗后12、24、48 h的p(CO_2)水平较同时间点的对照组降低更为显著(P<0.05)。观察组治疗后12、24、48 h的p(O_2)水平较同时间点的对照组升高更为显著(P<0.05)。观察组p(O2)/FiO_2在治疗后12、24 h较同时期对照组显著更高(P<0.05)。观察组的上机时间以及撤机后的氧疗时间均显著短于对照组(P<0.05)。结论盐酸氨溴索联合牛肺表面活性物质治疗早产新生儿呼吸窘迫综合征,能早期有效的提高氧分压以及氧合指数,降低二氧化碳分压,降低辅助通气以及氧疗时间。

Objective To explore the clinical effect of ambroxol hydrochloride combined with bovine pulmonary surfactant on treatment of premature neonates with respiratory distress syndrome. Methods Totally 50 premature neonates with respiratory distress syndrome were divided into separate application with bovine pulmonary surfactant group （control group） and bovine pulmonary surfactant combined with injection of ambroxol hydrochloride group （observation group）. The oxygen partial pressure [p（O2 ） ], carbon dioxide partial pressure [p（ CO2 ） ] and calculation of oxygenation index [p（O2）/FiO2 ] at 1, 12, 24, 48 h after treatment were compared between two groups, and the ventilator treatment time, oxygen therapy time and hospitalization time were observed. Results The p（ CO2 ） levels in the observation group at 12, 24 and 48 h after treatment were significantly lower than those in the control group at the same time points （P 〈 0.05 ）. The p （ O2 ） levels in the observation group at 12, 24 and 48 h after treatment were significantly higher than those in the control group at the same time points （ P 〈 0.05 ）. The p （ O2 ）/FiO2 in the observation group were significantly higher than the control group at 12 and 24 h after treatment （P 〈 0.05 ）. The time of ventilator treatment and oxygen therapy time in the observation group were significantly shorter than the control group （ P 〈 0. 0 5 ） . Conclusion In treatment of premature neonates with respiratory distress syndrome , ambroxol hydrochloride combined with bovine pulmonary surfactant can effective improve early oxygen partial pressure and oxygen index, reduce partial pressure of carbon dioxide, and shorten auxiliary ventilation and oxygen therapy time.