早期应用INSURE技术治疗新生儿呼吸窘迫综合症的临床研究  

A Clinical Study on Early Applying of Intubation-Surfactant-Extubation in Treatment of Neonatal Respiratory Distress Syndrome

作　　者：刁诗光[1] 何定鑫 王冬妹[1] 刘晓燕[1] 

机构地区：[1]广东省韶关市粤北人民医院儿科,512025 [2]广东省韶关市曲江区人民医院儿科

出　　处：《中华全科医学》2013年第3期392-394,共3页Chinese Journal of General Practice

摘　　要：目的探讨早期应用INSURE技术治疗新生儿呼吸窘迫综合症的疗效,安全性,可靠程度和操作性。方法新生儿呼吸窘迫综合症35例经气管插管应用固尔苏(外源性肺表面活性物质,简称:PS),确诊后PS按200 mg/kg,单体位一次性快速气管导管内注入。随机分为两组,对照组(A组)20例采用常规机械通气治疗;观察组(B组)15例早期采用INSURE技术治疗。观察两组患儿的临床转归和并发症的发生率,并监测在诊断确立(基础值)、治疗后2,6,12,24 h,各个时间观察点的PaO2、氧合指数(OI)值。结果 B组患儿住院时间缩短,呼吸机相关性肺炎等并发症显著降低。在治疗后24 h内的各个时间观察点OI显著低于A组(P<0.05～0.01),即B组氧合功能较A组改善快。结论早期应用INSURE技术治疗新生儿呼吸窘迫综合症的可提高疗效,缩短住院时间,显著降低呼吸机相关性肺炎等并发症。Objective To assess the efficacy of Intubation-Surfactant-Extubation（INSURE） in the treatment of neonatal respiratory distress syndrome（RDS）.Methods Thirty five infants with RDS were randomly divided into two group（20 patients in group A as control and 15 patients in group B as observation）,the curosurf（a pulmonary surfactant,PS,200 mg/kg） was dropped into the intracheal tubes at beginning with all infants,group A received mechanical ventilation,group B received NCPAP,the outcomes and rate of complications were observed,and PaO2,oxygenation index were determined at different time points during 24 h of treatment.Results In group B,the hospitalization time was short,the rate of complications such as ventilator-associated pneumonia decreased.The oxygenation index in groups B was significantly lower than that in group A at different time points during 24h of treatment（P0.05 to 0.01）.Conclusion The combined use of exogenous PS and NCPAP can exert synergetic therapeutic effect on the neonatal RDS,shorten the hospitalization time and decrease the rate of complications.

关 键 词：肺表面活性物质 NCPAP 新生儿 呼吸窘迫综合症 

分 类 号：R722.1[医药卫生—儿科]