摘要
目的:观察氨溴索辅助高频振荡通气治疗重症新生儿胎粪吸入综合征(MAS)的疗效。方法:选择符合新生儿胎粪吸入综合征诊断标准需机械通气治疗的足月新生儿16例,开始高频通气同时予氨溴索15 mg/kg静脉推注,6 h 1次,连用5天。观察治疗开始0 h、2 h、8 h、24 h、48 h FiO2、PaO2、a/APO2、PaCO2及Paw的动态变化。结果:应用氨溴索辅助高频通气后2 h,FiO2由(0.85±0.10)下降至(0.69±0.12)(P<0.05),a/APO2、PaO2由(0.10±0.03,38.9±4.3mmHg)上升至(0.21±0.06,48.1±3.6 mmHg)(P<0.05),以后FiO2继续下降,PaO2、a/A逐步上升;PaCO2在2 h内也有下降,由治疗前的(68.1±6.9 mmHg)到(60.2±5.5 mmHg)(P<0.05),8 h下降更加明显(P<0.01),Paw在8 h也开始由(15.3±1.8 cm H2O)降低至(13.2±2.5 cm H2O),与治疗前比较差异有显著性意义(P<0.05)。结论:氨溴索能提高MAS患儿通气及换气功能,降低呼吸机参数,减少肺损伤的发生。
Objective: Evaluation the effect of Ambroxol on neonatal meconium aspiration syndrome (MAS) under high frequency oscillation. Methods: 16 MAS patients were treated by Ambroxol with high frequency oscillation. Ambroxol (15 mg/kg) was given every six hours in five continuous days. FiO2、Paw、a/APO2、PaO2、PaCO2、incidence of complications and mortality were investigated at 2 h,8 h,24 h,48 h after first dose of Ambroxol. Results: Blood gas exchanges and hemodynamics were evaluated before and after treatment. In the first 2 h of treatment FiO2 rapidly decreased from(0.85±0.10) to (0.69±0.12)(P<0.05) ,a/APO2 and PaO2 increased from (0.10±0.03,38.9±4.3 mmHg) to (0.21±0.06,48.1±3.6 mmHg)(P<0.05), PaCO2 decreased from (68.1±6.9 mmHg) to (60.2±5.5 mmHg)(P<0.05),and reduced significandy at 8 h to (50.5±5.9 mmHg) (P<0.01). Paw decreased at 8 h from(15.3±1.8 cm H2O) to (13.2±2.5 cm H2O)(P<0.05). Conclusion: Ambroxol can improve pulmonary exchang function of the patients with MAS,reduce MAP,FiO2 of the patients with ventilation and incidences of air leak and lung injury.
出处
《岭南急诊医学杂志》
2004年第2期97-98,105,共3页
Lingnan Journal of Emergency Medicine
