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盐酸氨溴索治疗新生儿感染性肺炎的疗效观察

来源:用户上传      作者: 陈玲

  [摘要] 目的 探讨盐酸氨溴索治疗新生儿感染性肺炎的疗效。 方法 90例感染性肺炎的新生儿按照入院顺序分为治疗组和对照组,对照组采用常规治疗,治疗组在对照组的基础上雾化吸入盐酸氨溴索治疗,两组均以5 d为1个疗程,比较两组患儿的疗效、血氧饱和度、临床症状和体征恢复正常的时间。 结果 治疗组总有效率为88.9%,显著高于对照组的62.2%(P < 0.05)。治疗组动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)的改善显著优于对照组(P < 0.05),且治疗组的呼吸困难改善时间、吸痰次数、氧疗时间、住院时间均显著短于对照组(P < 0.05)。 结论 盐酸氨溴索能够显著促进感染性肺炎新生儿排痰,改善通气,提高治疗效果。
  [关键词] 盐酸氨溴索;新生儿;感染性肺炎;疗效;血氧饱和度
  [中图分类号] R563.1 [文献标识码] A [文章编号] 1673-7210(2012)08(a)-0091-02
  Observation on curative effect of Ambroxol Hydrochloride in the treatment of neonatal pneumonia
  CHEN Ling
  Department of New Pediatrics, the Second People's Hospital of Xintai City, Shandong Province, Xintai 271219, China
  [Abstract] Objective To investigate the curative effect of Ambroxol Hydrochloride in the treatment of neonatal pneumonia. Methods 90 cases of infectious pneumonia in the newborn were divided into the treatment group and the control group according to the order of hospitalization, the control group was given conventional treatment, the treatment group was given atomization inhalation of Ambroxol Hydrochloride, 5 d was needed for a course of treatment, two groups were compared with curative effect oxygen saturation, the time of clinical symptoms and signs return to normal time. Results The total effective rate was 88.9% in the treatment group, which was higher than 62.2% in the control group (P < 0.05). In the treatment group, the improvement of arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2) were significantly better than those in the control group (P < 0.05). And dyspnea improved sputum suction time, frequency, oxygen therapy, duration of hospital stay in the treatment group were significantly shorter than that in control group (P < 0.05). Conclusion Ambroxol Hydrochloride can significantly promote infection pneumonia of newborn sputum excretion, improve ventilation and the treatment effect.
  [Key words] Ambroxol Hydrochloride; Neonatal; Pneumonia; Efficacy; Oxygen saturation
  感染性肺炎是新生儿的常见病,严重的情况下可导致急性呼吸窘迫综合征而导致患儿死亡,且日龄越小病死率越高[1]。早期诊断,及时治疗非常重要。临床上对新生儿感染性肺炎除了积极抗感染治疗外,肺功能保护、呼吸道的清理对改善患儿的预后有积极的作用[2]。盐酸氨溴索是一种呼吸系统的黏痰溶解药,刺激天然肺表面活性物质的产生和分泌,增加痰量,降低痰液黏度[3]。近年来,其用于新生儿感染性肺炎的辅助治疗,取得了满意的疗效。我科于2009年2月~2010年5月在常规治疗的基础上静脉滴入盐酸氨溴索治疗新生儿感染性肺炎45例,效果满意,现报道如下:
  1 资料与方法
  1.1 一般资料
  90例感染性肺炎的新生儿均符合第3版《实用儿科学》中新生儿感染性肺炎的诊断标准,Apgar评分3~7分,无先天畸形及遗传代谢性疾病。入选标准:①有产时窒息史或宫内窘迫;②口吐白沫,阵发性面部皮肤青紫;③吃奶差,反应差;④呼吸频率快、鼻扇、吸气三凹征、双肺可闻及细湿啰音及哮鸣音;⑤胸片提示肺纹理增粗或斑片状或斑点状影;⑥血气分析动脉血二氧化磷分压(PaCO2)≥50 mm Hg(1 mm Hg=0.133 kPa),动脉血氧分压(PaO2)≤50 mm Hg。⑦经医院伦理委员会通过,家属均签署知情同意书。其中男48例,女42例;年龄1~24 d,平均(15.5±4.5)d;胎龄(39.6±5.2)周;体重(3 150±280)g;顺产58例,剖宫产32例;足月儿58例,早产儿32例。将该组患儿按照入院的时间进行编号,奇数为对照组,偶数为治疗组,每组45例,两组在性别、年龄、胎龄、体重、病情、血气指标、分娩方式等方面差异均无统计学意义(P > 0.05),具有可比性。
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