盐酸氨溴索预防早产儿肺透明膜病时机探讨

目的研究盐酸氨溴索(商品名:沐舒坦)预防早产儿肺透明膜病(HMD)的用药时机。方法观察组(184例)为生后8h内入院尚未发生HMD,胎龄<35周的早产儿,入院后即予盐酸氨溴索30mg·kg-·1d-1,6h1次静脉注射,按用药时机的不同分为￣2h,￣4h,￣6h,￣8h4个小组,观察各组发生HMD的情况并与对照组比较。结果①观察组发生HMD12例(6.5%),对照组33例(18.3%),P<0.05。②观察1组、观察2组HMD发生率分别为2.4%、3.8%,与对照组比较分别为P1<0.01、P2<0.05;观察3组、观察4组HMD发生率分别为7.4%、13.9%,与对照组比较均为P>0.05。③观察组中需气管插管呼吸机辅助呼吸的HMD3例(25%),对照组为27例(81.8%),P<0.01。结论盐酸氨溴索能有效预防HMD发生,4h内用药效果显著,4h后用药预防作用下降但能减轻HMD病情、缩短病程及减少并发症的发生。

A study on seizing opportune moments to use mucosolvan for premature''''s hyaline membrane disease

Objective To choose opportune moments to use mucosolvan(ambroxol) for relieving hyaline membrane disease(HMD) of the premature. Methods One hundred and eighty-four prematures were treated with mucosolvan 30 mg·kg-1·d-1 given at different times after hospitalization:~2 h,~4 h,~6 h,~8 h,as four observed groups,the results were compared with contrast group. Results ①12(6.5%) out of 184 infants in the observed group developed HMD,while the contrast group had 33 developing HMD(18.3%).The difference was significant( χ2=11.72,P<0.01);②Comparing different treatment times,those groups treated within 2 or 4 hours,had HMD occurrence rates of 2.4%,3.8%,respectively,with a significant difference compared with contrast group(P1<0.01,P2<0.05).Group 3 and group 4 treated in 4~6 h,6~8 h,had HMD occurences of 7.4%,14% respectively,without significant difference,compared with contrast group (P>0.05);③There were 3 cases(25%) in observed groups who had to receive mechanical ventilation,while 27 cases(81.8%) in contrast gruop,with a significant difference(P<0.01). Conclusion Mucosolvan exerts an effective prevention against the HMD onset,the optimum moment is within 4 hours after birth;while after the postnatal 4 h the mucosolvan use got a decreased efficacy,but can still relieve the HMD condition,shorten its course,and reduce complications (if any).