经鼻持续正压通气治疗新生儿肺透明膜病的评价  

The effect of nasal continuous positive airway pressure in premature infants with hyaline membrane disease

作　　者：刘翠青[1] 李莉[1] 刘素哲[1] 马莉[1] 纪素粉[1] 

机构地区：[1]河北省儿童医院新生儿科

出　　处：《新生儿科杂志》2005年第1期19-22,共4页The Journal of Neonatology

摘　　要：目的评价经鼻持续正压通气(NCPAP)与常规机械通气(CMV)对新生儿肺透明膜病(HMD)的治疗效果和NCPAP是否降低呼吸机相关肺炎(VAP),呼吸机所致肺损伤(VILI)等发生。方法 对38例在我院新生儿科住院的HMD患儿进行临床观察,随机分为两组,NCPAP组18例,CMV组20例。所有38例患儿均在生后24小时内给予单剂猪肺表面活性物质(固尔苏120 mg／kg)。NCPAP组应用INFANTFLOW SYSTEM(英国EME公司产)呼吸机。CMV组应用VIP BIRD(美国产)呼吸机IPPV+PEEP。辅助呼吸。结果 存活:NCPAP组16／18例,CMV组成活17／20例,两组在存活率、用机时间、颅内出血上无显著差异,而在呼吸机相关性肺炎、呼吸机致肺损伤并发症上,NCPAP组明显低于CMV组,经X2检验两组差异有显著,P<0.05。结论NCPAP可有效地治疗新生儿HMD,并可明显减少VAP和VILI的发生。Objective To determine whether nasal continuous positive airway pressure (NCPAP) would decrease the ventilator induced lung injury (VILI) and ventilator associated pneumonia (VAP) compared to conventional mechanical ventilation (CMV) for neonates with Hyaline membrane disease (HMD). Methods We randomly assigned 38 infants with HMD entry the study. They had clinical and radiological findings of HMD at 2~24 hrs of age, a/A <0.02 and Ⅲ-Ⅳ degree intraventricular hemorrhage(IVH), pneumonia and pneumothraxs as well as malformations were ruled out.All 38 infants with HMD were treated with single dose surfactant, 120 mg/kg. (CUROSURF,made in ITALY).Eighteen infants were treated with NCPAP,Gestation age (30.1±2.7)wks,birth weight (1264±250)g,Twenty treated with CMV, gestation age (30.3±2.5)ws,birth weigth (1253±273) g. Results The ventilated duration (76±16)h and (72±12)h is NCPAP group and CMV group respectirely.NCPAP group had lower incidence of VILI and VAP (P<0.05).Contusions NCPAP is as efficient as CMV in HMD mangement, and it decreases the incidence of VAP and VILI. NCPAP shouldbe the first choice for HMD respiratory support.

关 键 词：NCPAP 治疗 呼吸机 CMV 经鼻 新生儿肺透明膜病 持续正压通气 结论 英国 目的 

分 类 号：R722.1[医药卫生—儿科]