氨溴索联合珂立苏对早产儿呼吸窘迫综合征的疗效观察

池婧涵

(北京军区总医院早产儿重症监护室，北京100700)

摘要：目的探讨氨溴索联合珂立苏(牛肺表面活性剂)对早产新生儿呼吸窘迫综合征(NRDS)的治疗疗效。方法 将85例诊断为NRDS患儿随机分成试验组43例和对照组42例。在采取机械通气等常规治疗方法的基础上，试验组加用氨溴索联合珂立苏治疗，对照组仅加用珂立苏治疗，连续用药4 d，比较2组疗效。结果 2组患儿的病情均有所改善，试验组治疗效果更佳。试验组患儿血气指标PaO2、PaCO2、pH、好转时间较对照组快(P<0.05)；治疗后X线胸片评分均下降，试验组治疗疗效明显优于对照组(P<0.001)；试验组机械通气时间、住院时间明显短于对照组(P<0.001)。结论 氨溴索联合珂立苏能明显改善早产儿呼吸窘迫综合征患儿的缺氧情况，预后良好，能有效减少机械通气时间与住院时间。

关键词：氨溴索；珂立苏；呼吸窘迫综合征；早产儿

doi:10.3969/j.issn.1004-2407.2015.06.025

中图分类号：R985文献标志码：A

收稿日期：(2015-04-30)

Observation of the effect of ambroxol with pulmonary surfactant (PS)-calsurf in the treatment of 85 premature infants with congenital neonatal respiratory distress syndrome

CHI Jinghan(Beijing Military Region General Hospital Intensive Care Unit in Preterm Neonates，Beijing 100700，China)

Abstract:ObjectiveTo investigate the effect of ambroxol with pulmonary surfactant(PS)-calsurf in the treatment of 85 premature infants with neonatal respiratory distress syndrome. Methods85 cases of children diagnosed with NRDS were randomly divided into experimental group (n=43) and the control group (n=42). In addition to conventional treatments such as mechanical ventilation， the experimental group were treated with ambroxol and calsurf ,while the control group were only treated with calsurf therapy. After 4 day’s continuous medication,the treatment effect was compared. ResultsBoth groups of patients had diseases remission and the experimental treatment group got better treatment effect. Blood gas analysis criteria of PaO2,PaCO2, and pH of the experimental group improved faster than the control group(P<0.05)；After treatment, the experimental group were significantly better than the control group(P<0.001)；The duration of mechanical ventilation and length of hospital stay of the experimental group were significantly less than the control group(P<0.001) .ConclusionAmbroxol with pulmonary surfactant (PS)-calsurf could significantly improve the situation of premature infants with respiratory distress syndrome,and the therapeutic method can effectively reduce the duration of mechanical ventilation and the length of hospital stay with good prognosis.

Key words: ambroxol;calsurf;neonatal respiratory distress syndrome ;premature infants

早产儿呼吸窘迫综合征(neonatal respiratory distress syndrome，NRDS)又名肺透明膜病，病因多见于肺表面活性物质(PS)的产生和分泌减少[1]。肺泡中广泛存在嗜伊红膜，弥漫性肺不张和肺顺应性降低等均为其发病的病理生理特征。疾病多发于早产儿，病死率较高，采用机械通气疗法疗效明显，但仅采用机械通气治疗往往存在气压伤、并发支气管、肺发育迟缓或不全等问题[2]。对机械通气疗法以及NICU技术的不断改进，可使早产儿呼吸窘迫综合征患儿的存活率明显提高[3]。本研究主要对我院收治的85例早生儿呼吸窘迫综合征患儿在机械通气治疗基础上，氨溴索联合珂立苏用药和仅给予珂立苏，观察并比较2种治疗方法的临床疗效。

1 资料与方法

1.1 临床资料选取我院2013年12月～2014年5月收治的早产儿呼吸窘迫综合征患儿85例，利用随机数字表法分为试验组43例和对照组42例。……