经鼻间歇正压通气联合肺表面活性物质治疗极低体重新生儿呼吸窘迫综合征的研究  

Transnasal Intermittent Positive Pressure Ventilation Combined with Pulmonary Surfactant in the Treatment of Respiratory Distress Syndrome in Low Weight Neonates

作　　者：李烨 高智波 刘毓屾 赵荧 曾令超 LI Ye;GAO Zhibo;LIU Yushen(The Second Affiliated Hospital of Air Force Military Medical University,Shaanxi Xi'an 710038,China)

机构地区：[1]空军军医大学第二附属医院,陕西西安710038 [2]陕西省西安市人民医院/西安市第四医院病理科,陕西西安710000

出　　处：《河北医学》2022年第12期2013-2017,共5页Hebei Medicine

基　　金：陕西省重点研发计划项目,(编号:2022SF-504)。

摘　　要：目的:分析研究呼吸窘迫综合征的极低体重新生儿采用经鼻间歇正压通气联合肺表面活性物质治疗方法的效果。方法:回顾性分析2019年11月至2021年10月于我院产科分娩的116例确诊呼吸窘迫综合征的极低体重新生儿的临床资料,依据治疗方法的不同分为观察组和对照组,对照组患儿进行常规经鼻间歇正压通气治疗,观察组患儿进行肺表面活性物质联合经鼻间歇正压通气治疗。对比两组患儿治疗前后的血气分析、治疗效果、呼吸机辅助治疗时间、住院时间和各种并发症分布。结果:经不同方法治疗后,两组患儿治疗后pH值、PaO_(2)、血氧饱和度均明显高于治疗前,PaCO_(2)均明显低于治疗前,差异均有统计学意义(P<0.05)。观察组pH值、PaO_(2)、PaCO_(2)、血氧饱和度的治疗前后差值明显大于对照组,差异有统计学意义(P<0.05)。观察组患儿对于新生儿呼吸窘迫综合征的治疗总有效率显著高于对照组(P<0.05)。观察组患儿呼吸机辅助治疗时间、住院时间、有创机械通气时间均短于对照组(P<0.05)。观察组患儿相关并发症的总发生率低于对照组(P<0.05)。结论:呼吸窘迫综合征的极低体重新生儿采取肺表面活性物质联合经鼻间歇正压通气治疗效果明显,并且呼吸机辅助治疗时间及住院时间短、治疗相关的并发症发生率低,值得临床推广应用。Objective:To analyze the influence of transnasal intermittent positive pressure ventilation with pulmonary surfactant on low weight neonates with respiratory distress syndrome.Methods:The clinical data of 116 low weight neonates with respiratory distress syndrome who were delivered in obstetrics department of our hospital from November 2019 to October 2021 were retrospectively analyzed.They were divided into two groups,the observation group and the control group according to different treatment methods.The neonates in the control group were treated with routine transnasal intermittent positive pressure ventilation,while the neonates in the observation group were given pulmonary surfactant combined with transnasal intermittent positive pressure ventilation.The blood gas analysis,treatment effect,ventilator assisted treatment time,hospital stay and other related conditions and the incidence of ramification were compared between the two groups before and after treatment.Results:After treatment with different methods,the pH value,PaO_(2) and blood oxygen saturation of the two groups were significantly higher than those before treatment,while PaCO_(2) was significantly lower than those before treatment,and the differences were statistically significant(P<0.05).The difference of pH value,PaO_(2),PaCO_(2) and blood oxygen saturation before and after treatment in the observation group was significantly greater than that in the control group(P<0.05).The total effective rate of neonatal respiratory distress syndrome in the observation group was significantly higher than that in the control group(P<0.05).The time of ventilator-assisted treatment,hospitalization and invasive mechanical ventilation in the observation group were shorter than those in the control group(P<0.05).The total incidence of related complications in the observation group was lower than that in the control group(P<0.05).Conclusion:Pulmonary surfactant combined with transnasal intermittent positive pressure ventilation is effective for low weight neonates

关 键 词：肺功能 呼吸窘迫综合征 肺表面活性物质 机械通气 

分 类 号：R722.1[医药卫生—儿科]