经鼻持续气道正压通气与肺表面活性物质在新生儿呼吸窘迫综合征中的应用效果  

Application effect of nasal continuous positive airway pressure and pulmonary surfactant in neonatal respiratory distress syndrome

作　　者：王玉[1] 游楚明[1] 林莹梅 WANG Yu;YOU Chuming;LIN Yingmei(Department of Neonatology,Second People's Hospital of Guangdong Province,Guangzhou,Guangdong,510310,China)

机构地区：[1]广东省第二人民医院新生儿科,广东广州510310

出　　处：《当代医学》2023年第28期32-35,共4页Contemporary Medicine

摘　　要：目的探讨经鼻持续气道正压通气(nCPAP)与肺表面活性物质(PS)在新生儿呼吸窘迫综合征(NRDS)中的应用效果。方法选取2019年4月至2021年5月广东省第二人民医院收治的180例NRDS患儿作为研究对象,按照随机数字表法分对照组与观察组,各90例。对照组接受PS治疗,观察组接受nCPAP治疗,比较两组临床疗效、动脉血气指标、临床治疗指标及并发症发生情况。结果两组治疗总有效率比较差异无统计学意义。治疗后,两组动脉血氧分压(PaO2)、吸入氧浓度分数(FiO2)均低于治疗前,差异有统计学意义(P<0.05),治疗前后pH比较差异无统计学意义,但两组间PaO2、pH、FiO2比较差异无统计学意义。两组氧疗时间、住院总时间比较差异无统计学意义;观察组治疗总费用低于对照组,差异有统计学意义(P<0.05)。两组气胸、感染、鼻黏膜损伤、肺出血发生率比较差异无统计学意义。结论nCPAP与PS治疗NRDS的疗效基本相当,但nCPAP治疗过程中气胸发生率相对较高,PS治疗费用高且存在损伤性,临床可根据患者实际状况选择合适的治疗方式。Objective To investigate the application effect of nasal continuous positive airway pressure(nCPAP)and pulmonary surfactant(PS)in neonatal respiratory distress syndrome.Methods 80 children with neonatal respiratory distress syndrome admitted to the Second People's Hospi-tal of Guangdong Province from April 2019 to May 2021 were selected as the study subjects,and they were divided into the control group and the ob-servation group by random table number method,with 90 cases in each group.The control group received PS treatment,and the observation group re-ceived nCPAP treatment,the clinical efficacy,arterial blood gas indexes,clinical treatment indexes and complications were compared between the two groups.Results There was no significant difference in the total effective rate between the two groups.After treatment,partial pressure of oxy-gen(PaO2)and fraction of inspire oxygen(FiO2)of the two groups were lower than those before treatment,and the differences were statistically sig-nificant(P<0.05),there was no significant difference in pH before and after treatment,but there was no significant difference in PaO2,pH and FiO2 between the two group.There were no significant differences in oxygen therapy time and total hospital stay between the two groups;the total treatment cost in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of pneumothorax,infection,nasal mucosal injury and pulmonary hemorrhage between the two groups.Conclusion The curative effect of nCPAP and ps in the treatment of neonatal respiratory distress syndrome is basically the same,but the incidence of pneumothorax is relatively high during the treatment of nCPAP,and the treatment of PS is costly and damaging,so the appropriate treatment mode can be selected according to the actual situation of patients.

关 键 词：新生儿呼吸窘迫综合征 肺表面活性物质 经鼻持续气道正压通气 血气指标 

分 类 号：R722.1[医药卫生—儿科]