喘乐宁吸入对机械通气呼吸窘迫综合征患儿肺功能的影响  

Affection of ventoline aerosol inhaled on lung mechanics in ventilated acute neonatal respiratory distress syndrome

作　　者：张慧[1] 薛辛东[1] 

机构地区：[1]中国医科大学附属第二医院儿科,沈阳110004

出　　处：《实用药物与临床》2005年第4期21-23,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨机械通气呼吸窘迫综合征(RDS)患儿在疾病急性期吸入喘乐宁后对肺功能的影响。方法在呼吸机参数一定的条件下,采用用药前后自身对照的方法,对15例机械通气的RDS患儿于生后7d内随机吸入相同剂量的喘乐宁及安慰剂,在给药前、后1h测定肺功能,同时监测动脉血气、心率(HR)及呼吸次数(RR),HR>200次/min时停止实验。运用配对t检验对用药前后各检测指标进行比较。结果15例机械通气的RDS患儿分别吸入喘乐宁及安慰剂各一喷。吸入喘乐宁后1h,气道阻力(Raw)、二氧化碳分压(PaCO2)及氧合指数(OI)较用药前有明显降低(P均<0.01);肺顺应性(Cdyn)较用药前亦有所改善(P<0.05);HR及RR与用药前相比则无明显差别(P>0.05)。吸入安慰剂后1h,各检测指标与用药前比较均无明显差异(P>0.05)。结论对于机械通气的RDS患儿在疾病急性期吸入喘乐宁可对肺顺应性和气道阻力等肺动力学指标有改善效应,并能促进CO2排除及氧合作用,目前尚未发现明显的临床副作用。Objective To evaluate the affection in lung mechanics of ventoline inhaled in ventilator-dependent acute respiratory distress syndrome （RDS） infants. Methods With the unchanged ventilator settings and posture, each subject was his own control subject and was randomly assigned to a placebo-ventoline or ventoline-placebo sequence administered on 2 consecutive days. The same dose was 2 puffs. Cdyn and Raw were measured prior and 1 hour after aerosol delivery . At the same time, blood gas was tested. Heart rates, respiratory rates and oxygen saturations were continuously monitored during the study period. The study must stop when the heart rates were more than 200bpm. Statistical analyses was paired Students（t） - test, a P value〈 0.05 was considered significantly. Results All 15 RDS infants needed mechanical ventilation, the studies were performed within 7 days after birth. Ventoline and placebo were inhaled 15 times each. After 1 hour of ventoline administration, a significant improvement in lung function was observed. Raw decreased （p 〈 0.01） and Cdyn increased （p 〈 0.05）. There was also a beneficial clinical response as demonstrated by decreased OI and PaCO2（p 〈 0.01）. Heart rate and respiratory rate were no clinical differences before and 1 hour after administration （p 〉 0.05）. There were no significant differences in placebo group （p 〉 0.05）. Conclusion Standardized bronchodilator therapy, may be of clinical value in the management of ventilator-dependent neonates with acute RDS.Resulting in improvement of Raw, Cdyn, oxygenation and elimination of CO2, without distinctive clinical sideeffect.

关 键 词：喘乐宁 机械通气 新生儿 肺功能 

分 类 号：R725.6[医药卫生—儿科]