双鼻塞持续气道正压通气与氨溴索联合治疗新生儿呼吸窘迫综合.docVIP

双鼻塞持续气道正压通气与氨溴索联合治疗新生儿呼吸窘迫综合 　　作者：贾永锋　　作者单位：陕西省商洛市妇幼保健院，陕西商洛 726000 　 【摘要】 目的：探讨在基层医院进行双鼻塞持续气道正压通气(CPAP)与盐酸氨溴索联合应用治疗新生儿呼吸窘迫综合征(NRDS)的疗效及临床价值。方法：对23例NRDS患儿进行CPAP通气的同时给盐酸氨溴索静脉注射加雾化治疗，观察治疗前后的血氧饱和度、X线胸片和临床效果。结果：与用药前相比，用药后6 h SpO2即明显升高，至12 h、24 h、36 h SpO2仍持续稳定在较高水平，差异有统计学意义。用药6 h，呼吸窘迫症状消失4例(17.4%)，明显改善18例(78.3%)，未减轻3例;48 h后，X线胸片显示肺野透明度明显改善18例(78.3%)。23例中治愈20例(87%)，1例死亡，2例家属签字放弃治疗。结论：CPAP与盐酸氨溴索联合应用治疗NRDS临床效果满意，经济有效，依从性好，值得在基层医院推广。 　　【关键词】 盐酸氨溴索;肺表面活性物质;双鼻塞持续气道正压通气;呼吸窘迫综合征 　　The continues positive airway pressure for double stuffy nose combined with ambroxol in treating the neonatal respiratory distress syndrome 　　JIA Yongfeng(Shangluo Women and Childrens Hospitial of Shanxi Province, Shanxi Shangluo 726000, China) 　　[Abstract] Object:To discuss the effects and the value of the continuous positive airway pressure (CPAP) combined with ambroxol for the double stuffy nose in treatment of neonatal respiratory distress syndrome (NRDS) in the hospital on primary level. Methods: 23 cases of NRDS were treated with the CPAP when ambroxol was added intravenously with atomization treatment, and then saturations of blood oxygen, X sternum and clinic effects were observed before and after the treatment. Results: Compared with those before the medication, SpO2 was obviously higher 6 hours after the medication and remained on high level 12, 24 and 36 hours after, with a significant statistical difference. Respiratory embarrassment symptom disappeared in 4 cases (17.4%) and improved in 16 cases (69.6%) and remained the same in 3 cases. After 48 hours, X sternum demonstrated improvement in the lung field transparency in 18 cases (78.3%). In 23 cases, 20 recovered (87%), 1 dyed, and 2 were given up treatment with family agreement. Conclusions: The clinic effect of CPAP combined with ambroxol hydrochloride in treatment of the NRDS is effective and economic with a good compliance and worth promoting in primary hospitals. 　　[Key words]Pulmonary surfactant; The double