氨溴索联合新型经鼻塞持续气道正压通气治疗 55 例新生儿肺透明膜病的临床分析

目的 探讨氨溴索联合新型经鼻塞持续气道正压通气（NCPAP）治疗新生儿肺透明膜病（NHMD）的效果及对并发症的影响。方法 选择浙江普陀医院2008年1月～2013年12月收治的NHMD患者55例，所有患者分为对照组和观察组。对照组27例，给予NCPAP等综合治疗，观察组28例，在对照组基础上联合氨溴索治疗。观察两组患者治疗效果。结果 ①观察组总有效率为89．29％（25／28），高于对照组的66．67％（20／27）．差异有统计学意义（P〈0．05）；观察组无效率为10．71％（3／28），低于对照组的33．33％（9／27），差异有统计学意义（P〈0．05）。②观察组通气24、48h的氧分压（PaO2）分别为（62．69±2．51）、（79．32±2．85）mmHg（1mmHg=0．133kPa），均高于对照组（51．37±2．64）、（70．58±2．76）mmHg]，差异有统计学意义（P〈0．05）；观察组通气24、48h的二氧化碳分压（PaCO2）分别为（53．38±2．06）、（48．53±1．94）mmHg，均低于对照组（58．26±2．14）、（53．02±2．12）mmHg]，差异有统计学意义（P〈0．05）；观察组通气24、48h的PaO2/FiO2分别为（18．58±1．62）、（22．64±1．15），均高于对照组（58．26±2．14）、（19．83±1．10）]，差异有统计学意义（P〈0．05）。③观察组并发症发生率为17．86％（5／28），低于对照组的48．15％（13／27），差异有统计学意义（P〈0．05）；观察组住院天数为（25．34±1．92）d，低于对照组的（30．82±2．21）d，差异有统计学意义（P〈0．05）。结论 氨溴索联合NCPAP治疗NHMD患儿效果较好，能够减少并发症，有效地改善肺功能。

Clinical effect analysis of Ambroxol combined with new nasal continuous positive airway pressure treatment for 55 patients with neonatal hyaline membrane disease

Objective To explore the therapeutic effect and complications of ambroxol combined with new nasal continuous positive airway pressure （NCPAP） treatment of neonatal pulmonary hyaline membrane disease （NHMD）. Methods 55 NHMD patients were selected from Putuo Hospital of Zhoushan City, from January 2008 to December 2013, all patients were divided into the control group and the observation group. 27 cases in control group were treated with NC- PAP therapy, 28 cases in observation group were treated with Ambroxol treatment on the basis of the control group. Results ①The total effective rate of the observation group was 89.29% （25/28）, it was higher than that of the control group 66.67% （20/27）], the difference was statistically significant （P 〈 0.05）. The invalid rate of the observation group was 10.71% （3/28）, it was lower than that of the control group 33.33% （9/27）], the difference was statistically significant （P 〈 0.05）. ②The PaO2 ventilation for 24, 48 h in observation group were （62.69±2.51）, （79.32±2.85） mm Hg respectively, they were all higher than those in control group （51.37±2.64）, （70.58±2.76） mmHg], the differences were statistically significant （P 〈 0.05）. The PaCO2 ventilation for 24, 48 h in observation group were （53.38±2.06）, （48.53±1.94） mm Hg respectively, they were all lower than those in control group （58.26±2.14）, （53.02±2.12） mm Hg], the differences were statistically significant （P 〈 0.05）. The PaO2/FiO2 ventilation for 24, 48 h in observation group were （18.58±1.62）, （22.64±1.15） respectively, they were all higher than those in control group （58.26±2.14）, （19.83±1.10）], the differences were statistically significant （P 〈 0.05）.③The complication occurrence rate of the observation group was 17.86% （5/ 28）, it was lower than that of the control group 48.15% （13/27）], the difference was statistically significant （P 〈 0.05）. The hospitalization time of the observation group was （25.34±1.92） d, it was lower than that of the control group （30.82±2.21）d], the difference was statistically significant （P 〈 0.05）. Conclusion Ambroxol combined with NCPAP for the treatment of NHMD in children has good effect, which can reduce the complications and improve lung function.