不同给止血药途径联合机械通气治疗新生儿肺出血的临床观察

Clinical Observation of Different Hemostatic Routes Combined with Mechanical Ventilation in the Treatment of Neonatal Pulmonary Hemorrhage

目的探讨新生儿肺出血的治疗中,使用不同的止血药给药途径联合机械通气治疗的效果。方法将本院2017年4月至2018年8月收治的66例新生儿肺出血患儿随机分成观察组(n=33)与对照组(n=33),两组均予以保暖、气管插管及机械通气等常规治疗,在此基础上予以对照组实施机械通气+静脉滴住蛇毒血凝酶的治疗方法,予以观察组实施机械通气+气管内滴入蛇毒凝血酶的治疗方法,观察两组患儿治疗效果及治疗安全性。结果观察组患儿机械通气时间、肺出血停止时间及住院时间均显著短于对照组(P<0. 05);观察组治疗总有效率为96. 97%,明显高于对照组78. 79%的总有效率(P<0. 05);治疗期间,观察组出现1例(3. 03%)不良反应,对照组出现2例(6. 06%)不良反应,两组对比差异无统计学意义(P>0. 05)。结论针对新生儿肺出血患儿,采取气管内滴入蛇毒凝血酶联合机械通气的治疗方法,可显著改善患儿临床症状,提高治疗效果,且用药安全性也非常高,值得推广。

Objective To investigate the effect of different hemostatic routes combined with mechanical ventilation in the treatment of neonatal pulmonary hemorrhage. Methods 66 patients with neonatal pulmonary hemorrhage admitted to our hospital between April 2017 and August 2018 were randomly divided into observation group( n = 33) and control group( n = 33). The two groups were treated with conventional treatment such as warm-keeping,tracheal intubation and mechanical ventilation. Based on the conventional treatment,those in the control group were given mechanical ventilation combined with intravenous instillation of snake venom thrombin. Those in the observation group were given mechanical ventilation combined with endotracheal instillati on basis of the snake venom thrombin. Treatment effect and the security in two groups were observed. Results Mechanical ventilation time,stopping time of pulmonary hemorrhage and hospitalization time in the observation group were significantly shorter than those in the control group( P <0. 05). The total effective rate of the treatment for observation group was 96. 97%,significantly higher than that in the control group( 78. 79%)( P < 0. 05). During the treatment,1 case( 3. 03%) of adverse reactions occurred in the observation group,and 2 cases( 6. 06%) of adverse reactions occurred in the control group. The difference between the two groups was not statistically significant( P>0. 05). Conclusion For neonatal patients with pulmonary hemorrhage,the treatment of endotracheal instillation of snake venom thrombin combined with mechanical ventilation can significantly improve the clinical symptoms of the patients and the treatment effect,and the medication safety is also very high,which is worthy of promotion.