猪肺表面活性物质联合氨溴索治疗新生儿肺透明膜病84例疗效观察  

The clinical efficacy and safety of pulmonary surfactant combined with ambroxol in the treatment of 84 neonatal hyaline membrane disease

作　　者：龚志敏 GONG Zhimin(Department of Neonatology,Ma anshan Maternal and Child Health Care Center Neonatal,Ma anshan,Anhui 243011,China)

机构地区：[1]马鞍山市妇幼保健院新生儿科

出　　处：《安徽医药》2019年第8期1681-1684,共4页Anhui Medical and Pharmaceutical Journal

基　　金：国家科技支撑计划(2012BAI32B00)

摘　　要：目的观察猪肺表面活性物质联合氨溴索治疗新生儿肺透明膜病(neonatal hyaline membrane disease,NHMD)的临床效果与安全性。方法回顾性分析2016年6月至2018年4月马鞍山市妇幼保健院收治的84例NHMD病儿临床资料,以开始治疗时的出生时间为分组依据,分为生后<4 h组(43例)和生后≥4 h组(41例)。比较两组病儿治疗前后血气分析指标、临床疗效、症状缓解时间、氧疗时间、持续正压通气(continuous positive airway pressure,CPAP)时间、住院时间以及不良反应发生情况。结果生后<4 h组病儿治疗后的动脉血氧分压(PaO2)水平(69.26±7.14) mmHg较治疗前(40.41±5.27) mmHg明显升高,治疗后动脉血二氧化碳分压(PaCO2)(35.46±4.23) mmHg及吸入氧浓度(FiO2)(50.45±5.33)%较治疗前(51.32±5.17) mmHg及(81.06±6.67)%均显著降低,生后≥4 h组病儿治疗后的PaO2水平(60.47±6.39) mmHg较治疗前(41.77±5.18) mmHg也明显升高,治疗后PaCO2(41.77±4.68) mmHg及FiO2(54.13±4.79)%较治疗前(52.04±6.25) mmHg及(82.11±5.76)%也显著降低,且生后<4 h组病儿显著优于生后≥4 h组,差异有统计学意义(P<0.05)。生后<4 h组病儿症状缓解时间(11.36±2.47) h、氧疗时间(7.16±2.32) d、CPAP时间(3.15±1.43) d及住院时间(13.46±3.21) d均显著短于生后≥4 h组病儿(19.86±4.35) h、(8.93±3.11) d、(4.76±1.52) d及(16.39±3.62) d,均差异有统计学意义(P<0.05)。生后<4 h组总有效率为95.35%,显著高于生后≥4 h组(80.49%),差异有统计学意义(P<0.05)。治疗期间,两组病儿均未发生明显的不良反应或者并发症,治疗方案安全性均较好。结论猪肺表面活性物质联合氨溴索治疗NHMD具有较好的临床疗效,能够明显改善病儿相关症状,并发症较少、安全性较高,且越早使用改善效果越好。Objective To investigate the clinical efficacy and safety of pulmonary surfactant(PS) combined with ambroxol in the treatment of neonatal hyaline membrane disease(NHMD).Methods Eighty-four cases newborns with NHMD in Ma’anshan Maternal and Child Health Care Center Neonatal from June 2016 to April 2018 were enrolled and retrospectively analyzed.Based on the starting treatment time,they were assigned into groups with postnatal<4 h(43 cases) and postnatal ≥4 h(41 cases).The blood gas analysis indexes,clinical efficacy,symptoms remission time,oxygen therapy time,CPAP time,hospital stay,and adverse reactions were compared between the two groups.Results In postnatal<4 h group,the arterial partial pressure of oxygen(PaO2) level [(69.26±7.14) mmHg]was significantly higher than that before treatment [(40.41±5.27) mmHg],while the arterial blood carbon dioxide partial pressure(PaCO2) and inhaled oxygen concentration(FiO2) were significantly lower than that before treatment [(35.46±4.23) mmHg vs.(51.32±5.17) mmHg,(50.45±5.33)% vs.(81.06±6.67)%,respectively].In postnatal ≥4 h group,The levels PaO2[(60.47±6.39) mmHg] was significantly higher than that before treatment [(41.77±5.18) mmHg],PaCO2 and FiO2 was significantly lower than that before treatment [(41.77±4.68) mmHg vs.(52.04±6.25) mmHg,(54.13±4.79)% vs.(82.11±5.76)%,respectively].and the children in the<4 h group after birth were significantly better than in the ≥4 h group after birth,the difference was statistically significant(P<0.05).The symptoms remission time,oxygen therapy time,CPAP time,hospital stay in postnatal<4 h group were significantly shorter than that in postnatal ≥4 h group [(11.36±2.47) h vs.(19.86±4.35) h,(7.16±2.32) d vs.(8.93±3.11) d,(3.15±1.43) d vs.(4.76±1.52) d,(13.46±3.21) d vs.(16.39±3.62) d,respectively,all P<0.05).The total effective rate of postnatal<4 h group was 95.35%,which was significantly higher than(80.49%) of postnatal ≥4 h group,and the difference had statistical difference(P<0.05).During the treatment

关 键 词：透明膜病 肺表面活性物质相关蛋白质类 氨溴索 猪 新生儿 治疗结果 

分 类 号：R722.1[医药卫生—儿科]