The efficacy comparison of pulmonary surfactant and ambroxol hydrochloride for treating neonatal hyaline mem-brane disease

QI Rong; LI Yuan; TANG Jin; YANG Jinwei

doi:10.3969/j.issn.1671-6450.2016.05.019

Abstract：Objective To study the effect of pulmonary surfactant and ambroxol hydrochloride on the treatment of hy-aline membrane disease.Methods 66 children with hyaline membrane disease in Neonatal Department,the People's Hospital of Baoji City from July 2013 to April 2015.They were divided randomly into observation group and control group,33 patients for each group.The observation group was treated with pulmonary surfactant, and the control group was treated with ambroxol hydrochloride.The therapeutic effect, and the changes of blood gas index and mechanical ventilation parameters before and af-ter treatment in two groups were compared.Required oxygen time, continuous positive airway pressure ( CPAP) time, hospital stay, and hospital costs were observed in both groups.Results The total effective rate of children in the observation group was 87.88% (29/33), significantly higher than 63.64% (21/33) in the control group, and that’ s a statistically significant difference ( t =5.280, P <0.05) .The arterial partial pressure of carbon dioxide ( PaCO2 ) after treatment for 3days in the observation group was lower than the control group [(4.02 ±1.01) kPa vs.(6.05 ±1.28) kPa], and oxygenation index (PaO2/FiO2), arterial oxygen partial pressure (PaO2), pH value was higher than the control group[(455.24 ±25.21)mm-Hg, (12.03 ±3.13) kPa, (9.97 ±1.21) vs.(406.02 ±27.18)mmHg, (9.07 ±1.36) kPa, (8.01 ±1.22)], and those were statistically significant differences ( t =7.152, t =7.627, t =4.983, t =6.553, P <0.05).Positive end-expiratory pressure ( PEEP) , mechanical ventilation frequency ( F) , airway peak pressure ( PIP) , mean airway pressure ( MAP) and inhaled oxygen concentration (FiO2) index were obviously lower than the control group [(36 ±7)times/min,(3.21 ±0.55) cmH2O,(16.98 ±3.01) cmH2O, (7.98 ±2.01) cmH2O, (0.37 ±0.04) % vs.(40 ±8)times/min,(3.82 ±0.76) cmH2O,(19.04 ±3.62) cmH2O, (9.87 ±2.88) cmH2O, (0.48 ±0.11)%], that’s a statistically significant difference (t =3.735, t =2.162, t =2.514, t =3.135, t =5.399, P <0.05).Given oxygen time, CPAP time, hospitalization time significantly shorter than the control group[(12.23 ±2.41)d vs.(15.31 ±2.37)d, (4.02 ±1.03)d vs.(6.06 ±1.31)d, (18.45 ±4.81)d vs.(24.11 ±6.61)d], but the cost of treatment of children in observation group of (3.14 ±0.27) ×104 yuan was significantly higher than control group of (2.60 ±0.21) ×104 yuan, and those were statistically significant differ-ences( t =5.235, t =7.032, t =3.977, t =8.948, P <0.05).Conclusion There is a good curative effect of taking a lung surface active material on treating neonatal pulmonary hyaline membrane disease , but the treatment cost of ambroxol hydrochloride is relatively low, to a certain extent, it can ease the financial burden of patients, and from the perspective of e-conomic and practical, it can be used as adjuvant drugs for the treatment of neonatal pulmonary hyaline membrane disease.