不同机械通气方式联合肺表面活性物质对新生儿急性呼吸窘迫综合征疗效比较  

Comparison of therapeutic effects of different mechanical ventilation combined with pulmonary surfactant on neonatal acute respiratory distress syndrome

作　　者：冯辉[1] 廖春玲[1] FENG Hui;LIAO Chunling(Department of Neonatology, Nanyang Second General Hospital, He’nan Nanyang 473000, China)

机构地区：[1]南阳市第二人民医院新生儿科,河南南阳473000

出　　处：《上海医药》2019年第3期46-48,共3页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:比较不同机械通气方式联合肺表面活性物质治疗新生儿呼吸窘迫综合征的临床疗效。方法:选取新生儿呼吸窘迫综合征患儿73例,根据不同治疗方式为观察组38例和对照组35例。观察组予经鼻持续正压通气(nasal continuous positive airway pressure, NCPAP)联合肺表面活性物质治疗,对照组予气管插管CMV或SIMV联合肺表面活性物质。比较两组治疗前、通气治疗后6、12、24、48～72 h血气分析结果,以及呼吸机使用、氧疗、住院时间、并发症发生情况及病死率。结果:治疗后两组不同时间点动脉血pH、PaO_2和PaCO_2与治疗前比较差异均有统计学意义(P<0.05),但同时间点组间比较差异无统计学意义(P> 0.05);观察组呼吸机使用、氧疗、住院时间、并发症发生率均低于对照组(P <0.05)。结论:NCPAP联合肺表面活性物质与CMV或SIMV联合肺表面活性物质治疗新生儿呼吸窘迫综合征均可改善患儿肺的氧合功能及肺部换气功能,疗效相似,但前者可缩短氧疗时间和住院时间,降低呼吸机相关并发症发生率。Objective: To compare the clinical efficacy of different mechanical ventilation combined with pulmonary surfactant in the treatment of neonatal respiratory distress syndrome. Methods: Seventy-three cases of neonatal respiratory distress syndrome were selected and divided into an observation group with 38 cases and a control group with 35 cases according to their different treatment methods. The observation group was treated with NCPAP combined with pulmonary surfactant while the control group with CMV or SIMV combined with pulmonary surfactant through tracheal intubation. The results of blood gas analysis before treatment and at 6, 12, 24, 48-72 hours after ventilation treatment, the ventilator use, the oxygen therapy, the hospital stay, the incidence of complications and mortality were compared between the two groups. Results: There were significant differences in arterial blood pH, PaO 2 and PaCO 2 between the two groups at different time points after treatment ( P <0.05), but there were no significant differences between the two groups at the same time point ( P >0.05). The use of ventilator, oxygen therapy, hospital stay and the incidence of complications were lower in the observation group than the control group ( P <0.05). Conclusion: NCPAP combined with pulmonary surfactant and CMV or SIMV combined with pulmonary surfactant in the treatment of neonatal respiratory distress syndrome can improve the pulmonary oxygenation function and pulmonary ventilation function, however the former can shorten the time of oxygen therapy and hospital stay and reduce the incidence of ventilator-related complications.

关 键 词：经鼻持续正压通气 控制性通气 同步间歇指令通气 肺表面活性物质 新生儿急性呼吸窘迫综合征 

分 类 号：R722.6[医药卫生—儿科]