新生儿呼吸窘迫综合征早期应用持续气道正压呼吸和肺泡表面活性物质防治研究  

Clinical effect of early application of continuous positive airway pressure and pulmonary surfactant in patients with neonatal respiratory distress syndrome

作　　者：由军[1] 傅聪[2] 侯学敬[1] 肖珊珊[1] 徐艳[1] 徐晓红[1] 

机构地区：[1]哈尔滨医科大学附属四院儿科,黑龙江哈尔滨150001 [2]黑龙江中医药大学

出　　处：《中国急救医学》2014年第7期641-643,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的研究新生儿呼吸窘迫综合征早期应用持续气道正压呼吸和肺泡表面活性物质的临床疗效。方法选择2012-01—2013—12我院收治的新生儿呼吸窘迫综合征病例96例，按照治疗方法分为研究组（48例）与对照组（48例），研究组采用鼻塞持续气道正压呼吸联合肺泡表面活性物质进行治疗，对照组仅使用肺表面活性物质治疗，比较分析两组临床疗效。结果研究组的治疗总有效率优于对照组（P〈0．05）。治疗2、12、24h后，研究组FiO2、PEEP、PaCO2均明显低于对照组（P〈0．05），血PaO2、pH值明显高于对照组（P〈0．05）。研究组并发症发生率明显低于对照组（P〈0．05），存活率明显高于对照组（P〈0．05）。结论新生儿呼吸窘迫综合征早期应用持续气道正压呼吸和肺泡表面活性物质防治效果显著，减少机械通气，应用价值较高，值得推广。Objective The present study aims to investigate the clinical effect of early application of continuous positive airway pressure and pulmonary surfactant on neonatal respiratory distress syndrome. Methods 96 cases of neonatal respiratory distress syndrome from January 2012 to December 2013 in our hospital were divided into the study group （48 cases） and control group （48 cases） according to the treatment methods. The study group was treated with nasal continuous positive airway pressure breathing combined with pulmonary surfactant in treatment; the control group was only treated by puhnonary surfactant. Clinical curative effect of the two groups was compared statistically. Results The treatment group showed better curative effect than the control group （ P 〈 0.05）. 2, 12 and 24 h after treatment, FiO2, PEEP and PaCO2 were significantly lower in the study group than those in the control group （ P 〈 0.05 ） ; blood PaO2, blood pH values were significantly higher in the study group than those in the control group （ P 〈 0.05 ）. Complications occurred fewer in the study group compared with the control group （ P 〈 0.05 ） , and the number of surviving patients was higher than that in control group （P 〈 0.05）. Conclusion Early application of continuous positive airway pressure and pulmonary surfactant treatment improves the curative effect on neonatal respiratory distress syndrome significantly. These treatments reduce mechanical ventilation and should be recommended in the clinic.

关 键 词：新生儿呼吸窘迫综合征(NRDS) 鼻塞持续气道正压(NCPAP) 肺泡表面活性物质(PS) 

分 类 号：R722.12[医药卫生—儿科]