肺表面活性物质联合机械通气治疗新生儿呼吸窘迫综合征的临床观察  

Clinical observation of lung surface active material combination of mechanical ventilation in the treatment of neonatal respiratory distress syndrome

作　　者：招军[1] 袁大华[1] 黄敏[1] 

机构地区：[1]广西柳州市人民医院儿科,广西柳州545006

出　　处：《现代预防医学》2013年第4期630-632,共3页Modern Preventive Medicine

摘　　要：目的观察肺表面活性物质联合机械通气在治疗新生儿呼吸窘迫综合征(NRDS)中的临床价值及疗效。方法将126例NRDS随机分组,其中A组64例给与肺表面活性物质联合机械通气治疗,B组22例给与肺表面活性物质(固尔苏)治疗,C组40例给与械通气治疗,观察治疗前后氧合指数(PaO2/FO2)、氧分压(PaO2)、二氧化碳分压(Pa-CO2)、pH值等指标变化。结果不同治疗方法对PaO2、PaCO2、PaO2/FO2、pH值的影响不同(F=3.25,F=3.31,F=3.42,F=0.73,P﹤0.05),A组明显优于其他两组(P﹤0.05);用药后不同时间PaO2、PaCO2、PaO2/FO2、pH值不同(F=3.87,F=3.42,F=3.53,F=0.84,P﹤0.05),PaO2、PaO2/FO2、pH值随时间延续治疗后不同时间点测量值均较治疗前升高(除pH值6h和12h时比较P﹥0.05外,其余P﹤0.05),PaCO2值随时间延续治疗后不同时间点测量值均较治疗前下降(P﹤0.05)。结论肺表面活性物质联合机械通气治疗NRDS在治疗后早期即能改善患儿PaO2/FO2、PaO2、PaCO,避免了病变的进一步加重,对降低患儿病死率具有重要意义。OBJECTIVE To observe lung surface active substances joint mechanical ventilation in the treatment of neonatal dis- tress syndrome （NRDS） and examine the clinical value and curative effect. METHODS 126 patients with NRDS were randomly assigned ; A group of 64 patients were given lung surface active substances to joint of mechanical entilation treatment; 22 cases in B group were given surface active substances to lung （firm Sue） treatment; 40 cases in group C were given entilation treat- ment. Oxygen index （PaOJFO2）, oxygen partial pressure （PaO2）, carbon dioxide points pressure （PaCO2）, PH value index changes were observed before and after treatment. RESULTS Different treatment methods had different Pa02, PaCO2, PaO2/ FO2, PH values （F = 3.25, F = 3.31, F = 3.42, F = 0.73, P 〈 0.05）, and group A was better than the other two groups （P 〈 0.05）. Pa02, PaCO2, PaO2/FO2, PH values were different after different time （F= 3.87, F= 3.42, F= 3.53, F= 0.84, P 〈 0.05）. Pa02, PaO2/F02, PH values were higher over time and at the different time point after treatment than before treatment （except the PH value of 6 h and 12 h are P〉 0.05 more than outside, P〈 0.05）. PaC02 value was lower over time and at the different time point after treatment than before treatment （P 〈 0.05）. CONCLUSION Pulmonary surface active material combi- nation of mechanical entilation in early NRDS after treatment can improve PaO2/F02, PaO2, PaCO, avoid the lesion accentuate further and reduce infant morality. It has important clinical implication.

关 键 词：新生儿呼吸窘迫综合征 肺表面活性物质 机械通气 

分 类 号：R174[医药卫生—妇幼卫生保健]