Therapeutic Effect of Bubble Nasal Continuous Positive Airway Pressure Combined With Ambroxol on Neonatal Respiratory Distress Syndrome

doi:10.3877/cma.j.issn.1673-5250.2012.02.015

Objective

To evaluate the effect of infant flow driver bubble nasal continuous positive airway pressure (IFD-BNCPAP) combined with large dose ambroxol in the prevention and treatment on neonatal respiratory distress syndrome(NRDS).

Methods

From October 2009 to September 2011, 79 premature infants who were born within 30 min and sent in department of neonatology were included in the study, and were divided randomly into treatment group(IFD-BNCPAP+ ambroxol, n=42) and control group (regular treatment, n=37). The vital sign, incidence rate of NRDS, usage rate of mechanical ventilation (MV), duration of ventilation and hospitalization, blood gas analysis results, respiratory index (RI), respiratory compliance(Crs), resistance(R) and pressure-volume curve (P-V) slope of curve were observed and statistically analyzed. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Hospital of Weifang Medical University.Informed consent was obtained from each parents.

Results

There were significant differences in incidence rate of NRDS and usage rate of MV between two groups(P<0.05). The duration of ventilation and hospitalization in treatment group was obviously lower than those in control group(P<0.05). The blood gas analysis results showed that there had significant difference in PaCO₂, RI, Crs, R and P-V slope of curve between two groups(P<0.05). There was no significant difference in incidence rate of complication between two groups(P>0.05).

Conclusions

The IFD-BNCPAP combined with large dose ambroxol on premature infants with NRDS had great effect in early time.This method can effectively improve oxygenation function, meanwhile can prevent and treat NRDS.

Key words: premature infant, respiratory distress syndrome, continuous positive airway pressure, ambroxol, prevention, treatmennt

表1 两组患儿预防效果比较(±s)

Table 1 Comparison of preventive effects between two groups(±s)

组别	n	NRDS发生率[n(%)]	MV使用率[n(%)]	通气时间(h)	住院时间(d)
治疗组	42	6(14.29)	5(11.91)	60.60± 7.89	20.24±2.43
对照组	37	12(32.43)	10(27.03)	96.80±10.14	24.14±2.14
χ²或t	?	3.69	4.34	－6.95	－7.53
P	?	<0.05	<0.05	<0.05	<0.05

表1 两组患儿预防效果比较(±s)

Table 1 Comparison of preventive effects between two groups(±s)

组别	n	NRDS发生率[n(%)]	MV使用率[n(%)]	通气时间(h)	住院时间(d)
治疗组	42	6(14.29)	5(11.91)	60.60± 7.89	20.24±2.43
对照组	37	12(32.43)	10(27.03)	96.80±10.14	24.14±2.14
χ²或t	?	3.69	4.34	－6.95	－7.53
P	?	<0.05	<0.05	<0.05	<0.05

表2 两组机械通气治疗前及12 h后血气分析结果比较(±s)

Table 2 Comparison of blood gas analysis results before and after 12 h of mechanical ventilation treatment between two groups (±s)

组别	PaO₂(mm Hg)		PaCO₂ (mm Hg)		pH值		OI		RI
组别	治疗前	12 h后	治疗前	12 h后	治疗前	12 h后	治疗前	12 h后	治疗前	12 h后
治疗组	60.00±1.01	72.80±1.93	51.00±2.74	45.60±1.14	7.34±0.02	7.38±0.03	113.75±8.24	145.60±3.85	5.23±0.51	4.12±0.13
对照组	53.60±1.27	66.90±1.53	56.90±2.13	51.50±1.58	7.33±0.02	7.37±0.02	93.76±7.36	118.10±10.40	6.28±0.58	5.11±0.50
t	9.82	6.50	－4.61	－7.38	0.11	1.04	4.77	5.63	－3.4	－4.27
P	<0.01	<0.01	<0.01	<0.01	>0.05	>0.05	<0.01	<0.01	<0.01	<0.01

表2 两组机械通气治疗前及12 h后血气分析结果比较(±s)

Table 2 Comparison of blood gas analysis results before and after 12 h of mechanical ventilation treatment between two groups (±s)

组别	PaO₂(mm Hg)		PaCO₂ (mm Hg)		pH值		OI		RI
组别	治疗前	12 h后	治疗前	12 h后	治疗前	12 h后	治疗前	12 h后	治疗前	12 h后
治疗组	60.00±1.01	72.80±1.93	51.00±2.74	45.60±1.14	7.34±0.02	7.38±0.03	113.75±8.24	145.60±3.85	5.23±0.51	4.12±0.13
对照组	53.60±1.27	66.90±1.53	56.90±2.13	51.50±1.58	7.33±0.02	7.37±0.02	93.76±7.36	118.10±10.40	6.28±0.58	5.11±0.50
t	9.82	6.50	－4.61	－7.38	0.11	1.04	4.77	5.63	－3.4	－4.27
P	<0.01	<0.01	<0.01	<0.01	>0.05	>0.05	<0.01	<0.01	<0.01	<0.01

表3 两组患儿相关呼吸力学参数比较(±s)

Table 3 Comparison of respiratory mechanical parameters between two groups(±s)

组别	Crs[mL/(cm H₂O·kg)]		R[cm H₂O/(L·S)]		P－V slope of curve
组别	24 h	72 h	24 h	72 h	24 h	72 h
治疗组	0.44±0.01	0.52±0.02	81.40±1.82	70.60±2.07	1.33±0.03	1.51±0.01
对照组	0.38±0.01	0.47±0.02	88.20±2.15	80.00±2.26	1.28±0.02	1.48±0.02
t	8.74	5.02	－6.05	－7.78	4.22	3.52
P	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01

表3 两组患儿相关呼吸力学参数比较(±s)

Table 3 Comparison of respiratory mechanical parameters between two groups(±s)

组别	Crs[mL/(cm H₂O·kg)]		R[cm H₂O/(L·S)]		P－V slope of curve
组别	24 h	72 h	24 h	72 h	24 h	72 h
治疗组	0.44±0.01	0.52±0.02	81.40±1.82	70.60±2.07	1.33±0.03	1.51±0.01
对照组	0.38±0.01	0.47±0.02	88.20±2.15	80.00±2.26	1.28±0.02	1.48±0.02
t	8.74	5.02	－6.05	－7.78	4.22	3.52
P	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01

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