CAJ | 학술논문

目的探讨适用于新生儿开胸术后更理想的雾化吸入方案,以促进患儿有效呼吸道分泌物引流,预防术后肺部并发症.方法 2011年1月至2013年10月本院新生儿外科收治的28 d以下开胸手术患儿60例,其中先天性食道闭锁45例,先天性膈疝15例.双盲随机分为两组,对照组30例,治疗组30例,治疗组给予沐舒坦7.5 mg加生理盐水2ml氧气驱动雾化吸入,对照组给予地塞米松1 mg、α-糜蛋白酶1000U加生理盐水10 ml超声雾化吸入.比较两组术后使用雾化吸入过程中血氧下降发生率及术后呼吸道恢复情况.结果治疗组术后3d之内血氧下降发生次数较对照组明显减少[第1天:(0.40±0.35)次vs.(1.53±1.04)次;第2天:(0.43±0.40)次vs.(1.10±1.06)次;第3天:(0.51±0.39)次vs.(1.20±1.09)次],差异有统计学意义(P＜0.05),人工吸痰次数明显减少[第1天:(7.37±4.92)次vs.(13.24±5.81)次;第2天:(6.34±3.84)次vs.(11.27±4.64)次;第3天:(6.01±2.23)次vs.(10.20±4.53)次](P＜0.05),治疗中未出现不良反应.术后4d后,治疗组和对照组在雾化吸入过程中血氧下降发生次数和人工吸痰次数比较,差异均无统计学意义(P＞0.05).结论新生儿开胸术后应用沐舒坦氧气驱动雾化吸入既改善呼吸状况,又促进痰液排出,而且雾化方法简便,易于操作,在临床应用中取得满意效果.
목적 탐토괄용우신생인개흉술후경이상적무화흡입방안,이촉진환인유효호흡도분비물인류,예방술후폐부병발증.방법 2011년1월지2013년10월본원신생인외과수치적28 d이하개흉수술환인60례,기중선천성식도폐쇄45례,선천성격산15례.쌍맹수궤분위량조,대조조30례,치료조30례,치료조급여목서탄7.5 mg가생리염수2ml양기구동무화흡입,대조조급여지새미송1 mg、α-미단백매1000U가생리염수10 ml초성무화흡입.비교량조술후사용무화흡입과정중혈양하강발생솔급술후호흡도회복정황.결과 치료조술후3d지내혈양하강발생차수교대조조명현감소[제1천:(0.40±0.35)차vs.(1.53±1.04)차;제2천:(0.43±0.40)차vs.(1.10±1.06)차;제3천:(0.51±0.39)차vs.(1.20±1.09)차],차이유통계학의의(P＜0.05),인공흡담차수명현감소[제1천:(7.37±4.92)차vs.(13.24±5.81)차;제2천:(6.34±3.84)차vs.(11.27±4.64)차;제3천:(6.01±2.23)차vs.(10.20±4.53)차](P＜0.05),치료중미출현불량반응.술후4d후,치료조화대조조재무화흡입과정중혈양하강발생차수화인공흡담차수비교,차이균무통계학의의(P＞0.05).결론 신생인개흉술후응용목서탄양기구동무화흡입기개선호흡상황,우촉진담액배출,이차무화방법간편,역우조작,재림상응용중취득만의효과.
Objective To explore the suitable protocols of thoracotomy inhalation program for newborns, which will help to promote respiratory tract secretion drainage and to prevent the postoperative pulmonary complications.Methods This was a double-blind,randomized clinical trial.From January 2011 to October 2013 ,a total of 60 neonatal cases received thoracotomy were recruited,which included 45 cases of congenital esophageal atresia, and 15 cases of congenital diaphragmatic hernia.All cases were randomly allocated into treatment group and control group.Treatment group received mucosolvan 7.5 mg and saline 2 ml oxygen driven inhalation and the control group was given dexamethasone 1 mg, α-chymotrypsin 1 000 U plus saline 10 ml ultrasonic atomizing inhalation.The postoperative incidence of blood oxygen falling when receiving atomizing inhalation and numbers of sputum suction were compared between two groups.Results Compared with control group, the incidences of drop of blood oxygen were significantly deceased [the first day:(0.40 ± 0.35) times vs.(1.53 ± 1.04) times;the second day: (4.32 ± 0.40) times vs.(1.10 ± 1.06) times;the third day: (0.51 ± 0.39) times vs.(1.20 ± 1.09) times;P ＜ 0.05], and the numbers of artificial sputum suction significantly deceased within 3 days after operation [the first day: (7.37 ± 4.92) times vs.(13.24 ± 5.81)times;the second day: (6.34 ± 3.84) times vs.(11.27 ± 4.64) times;the third day: (6.01 ± 2.23) times vs.(10.20 ± 4.53) times;P ＜ 0.05].No adverse reactions were found during treatment.The incidence of blood oxygen falling and the numbers of artificial sputum suction showed no significant differences between two groups on day 4 and day 5 after operation(P ＞ 0.05).Conclusion It is important to have mucosolvan inhalation program for improving condition of respiration and respiratory secretions drainage for newborns with thoracotomy mucosolvan oxygen driven inhalation is worthy being used widely.