早期应用持续气道正压通气治疗新生儿呼吸窘迫综合征临床观察  

Clinical observation of early application of intubation-surfactant-extubation in the treatment of neonatal respiratory distress syndrome

作　　者：韩文[1] 尹丽明[1] 冯晓英[1] 谢勇[1] 任淑颖[1] 轩永立 

机构地区：[1]克拉玛依市中心医院儿科,新疆克拉玛依834000

出　　处：《中华实用诊断与治疗杂志》2014年第2期193-194,共2页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的观察早期应用气管插管-肺表面活性物质注入-快速拔管后给予经鼻持续气道正压通气(intubation surfactant extubation,INSURE)技术治疗新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)的疗效。方法 NRDS患儿52例依据治疗方法不同分为2组,观察组28例均早期应用INSURE技术,对照组24例给予经鼻持续气道正压通气(nasal continuous positive airway pressure,nCPAP)治疗。比较2组治疗前及治疗后6、24h时pa(O2)、pa(CO2)、pa(O2)/吸氧浓度(fraction of inspiration O2,FiO2),及nCPAP使用时间与治疗成功率。结果 2组治疗6、24h后pa(O2)、pa(O2)/FiO2均较治疗前增高(P<0.05),观察组pa(CO2)较治疗前降低(P<0.05),对照组pa(CO2)与治疗前比较差异无统计学意义(P>0.05);2组治疗后24hpa(O2)、pa(O2)/FiO2及pa(CO2)比较差异有统计学意义(P<0.05);观察组nCPAP使用时间较对照组短、治疗成功率较对照组高(P<0.05)。结论早期应用INSURE技术治疗NRDS可改善患儿通气状况及氧合,缩短nCPAP使用时间,提高治疗成功率。。Objective To assess the therapeutic effect of early application of intubation-surfactant-extubation （INSURE） in the treatment of neonatal respiratory distress syndrome （NRDS）. Methods Fifty-two NRDS newborns were divided into two groups according to the treatment methods. Observation group （n=28） was treated with INSURE technique in early stage, and control group was treated with nasal continuous positive airway pressure （nCPAP）. pa（O2 ）, pa（CO2 ）, ratio of pa（O2 ） to fraction of inspiration 02 （FiO2）, nCPAP-use time and success rate were compared between two groups before treatment, and 6 and 24 hours after treatment. Results pa（O2）and pa（02 ）/FiO2 significantly increased in both groups and pa（CO2） significantly decreased in observation group 6 and 24 hours after treatment compared with before treatment （P^0.05）. There was no significant difference in pa（CO2 ） after treatment compared with before treatment in control group （P〈0.05）. There were significant differences in pa（O2）, pa（CO2） and pa（O2）/ FiO2 24 hours after treatment compared with before treatment in both groups （P〈0.05）. Observation group had shorter nCPAP-use time and higher success rate compared with control group （P〈0.05）. Conclusions Early application of INSURE can improve ventilation and oxygenation, shorten nCPAP-use time, and improve success rate for NRDS.

关 键 词：呼吸窘迫综合征 新生儿 持续气道正压通气 

分 类 号：R722.12[医药卫生—儿科]