猪肺磷脂联合新型鼻塞式持续气道正压通气治疗早产呼吸窘迫综合征的疗效观察  

Observation of poractant alfa combined nasal continuous positive airway pressure in the treatment of preterm neonatal respiratory distress syndrom

作　　者：林莉[1] 杨玉丽[1] 周国兵[1] 

机构地区：[1]湖南省衡阳市妇幼保健院NICU,湖南衡阳421001

出　　处：《中国当代医药》2010年第12期163-164,共2页China Modern Medicine

摘　　要：目的:探讨猪肺磷脂联合鼻塞式持续气道正压通气(NCPAP)对早产肺透明膜病(NRDS)的治疗作用。方法:对22例NRDS的早产儿经气管内滴入猪肺表面活性物质猪肺磷脂[poractamt alfa,200mg/(kg·次)],然后拔管予以NC-PAP呼吸支持治疗,观察治疗前后临床症状体征、血气、X线胸片。结果:与用药前相比,用药后1h呼吸窘迫症状消失8例(36%),明显减轻12例(95%),用药后0.5、6、12、24h血气PaO2pH值明显改善,差异均有统计学意义(P<0.01),用药后0.5、6、12、24hPaCO2明显下降,与用药前相比,差异均有统计学意义(P<0.01),22例中治愈21例,治愈率为95%,1例改为机械通气。结论:NCPAP与肺表面活性物质(PS)联合治疗NRDS,能快速有效地改善NRDS的肺通气和换气功能,并可减少并发症及减少机械通气率。Objective：To explore the treatment effect of nasal continuous positive airway pressure on preterm neonatal res piratory distress syndrome（NRDS）. Methods：Twenty two patients of NRDS were administrated with NCPAP after intratracheal instillation of poractant alfa[200 mg/（kg·dose）].Clinic signs and symptoms,blood gas analysis,chest X-ray were observed before and after the administration.Results：Compared with that before treatment,respiratory distress disappeared after treatment 1 hour in 8 cases（36%）,significantly reduced in 12 cases（95%）.Blood gas analysis, PaO2and pH were improved at the time of 0.5,6,12 and 24 hours after treatment.The differences were significantly（P〈0.01）.PaCO2decreased significantly 0.5,6,12,24 hours after treatment.The differences were significantly compared with that before （P〈0.01）.21 cases were cured in 22 cases,cure rate was 95%,and 1 case changed to mechanical ventilation.Conclusion：In preterm infants with respiratory distress syndrome,their prognosis can be improved by NCPAP combined with pulmonary surfactant.The treatment can improve the function on pulmonary ventilation and gas exchange,and reduce the complications and the rate of mechanical ventilation.

关 键 词：肺表面活性物质 鼻塞持续气道正压 早产呼吸窘迫综合征 

分 类 号：R56[医药卫生—呼吸系统]