气管插管给药与气管插管-肺表面活性物质-拔管后经鼻持续气道正压通气给药治疗新生儿呼吸窘迫综合征的临床疗效比较  

Comparison of clinical efficacy of tracheal intubation and tracheal intubation-pulmonary surfactant-intubation surfactant extubation-continuous positive nasal airway pressure ventilation in the treatment of neonatal respiratory distress syndrome

作　　者：肖勤 龙文香[1] 周福根[1] 龙小红[1] XIAO Qin;LONG Wenxiang;ZHOU Fugen;LONG Xiaohong(Newborn Department of Ji'an Maternal and Child Health Hospital,Jiangxi,Ji'an,343000,Chian)

机构地区：[1]吉安市妇幼保健院新生儿科,江西吉安343000

出　　处：《当代医学》2024年第15期8-12,共5页Contemporary Medicine

基　　金：吉安市指导性科技计划项目(2020-20-115)。

摘　　要：目的比较气管插管给药与气管插管-肺表面活性物质-拔管后经鼻持续气道正压通气(INSURE)给药治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法选取2020年2月至2022年12月吉安市妇幼保健院收治的80例NRDS患儿作为研究对象,根据随机数字表法分为常规组与观察组,每组40例。常规组予以气管插管给药,观察组予以INSURE给药,比较两组临床疗效、肺功能[最大通气量(MVV)、第1秒用力呼气容积(FEV_(1))、呼气流量峰值(PEF)]、动脉血气指标[氧合指数(PaO_(2)/FiO_(2))、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、并发症发生情况、治疗时间。结果观察组治疗总有效率为90.00%,高于常规组的70.00%,差异有统计学意义(P<0.05)。撤机后,两组MVV、FEV_(1)、PEF均大于上机前,且观察组大于常规组,差异有统计学意义(P<0.05)。撤机后,两组PaO_(2)、PaO_(2)/FiO_(2)均高于上机前,PaCO_(2)均低于上机前,且观察组PaO_(2)、PaO_(2)/FiO_(2)均高于常规组,PaCO_(2)低于常规组,差异有统计学意义(P<0.05)。观察组并发症发生率为12.50%,低于常规组的32.50%,差异有统计学意义(P<0.05)。观察组吸氧时间、通气时间、住ICU时间、总住院时间均短于常规组,差异有统计学意义(P<0.05)。结论与气管插管给药治疗相比,INSURE给药治疗NRDS的效果更佳,可改善患儿肺功能及血气指标,降低并发症发生率,有利于促进患儿尽快恢复健康,值得临床推广应用。Objective To compare the clinical efficacy of tracheal intubation and tracheal intubation-pulmonary surfactant-intubation surfactant extubation-continuous positive nasal airway pressure ventilation(INSURE)in the treatment of neonatal respiratory distress syndrome(NRDS).Methods s 80 children with NRDS admitted to our hospital from February 2020 to December 2022 were selected as the research subjects,and they were divided into the routine group and the observation group according to the random number table method,with 40 cases in each group.The routine group was given tracheal intubation,and the observation group was given INSURE,the clinical efficacy,pulmonary function(maximum volume of air volume[MVV],forced expiratory volume in the first second[FEV_(1)],peak expiratory flow[PEF]),arterial blood gas index(oxygenation index[PaO_(2)/FiO_(2)],arterial partial pressure of oxygen[PaO_(2)],arterial partial pressure of carbon dioxide[PaCO_(2)]),complication occurrence and treatment time were compared between the two groups.Results The total effective rate in the observation group was 90.00%,which was higher than 70.00%in the routine group,and the difference was statistically significant(P<0.05).After weaning,MVV,FEV_(1),PEF of the two groups were larger than those before starting the machine,and those in the observation group were larger than those in the routine group,and the differences were statistically significant(P<0.05).After weaning,PaO_(2),PaO_(2)/FiO_(2) of the two groups were higher than those before starting,while PaCO_(2) was lower than that before starting,and PaO_(2),PaO_(2)/FiO_(2) in the observation group was were higher than those in the routine group,PaCO_(2) was lower than that in the routine group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 12.50%,which was lower than 32.50%in the conventional group,and the difference was statistically significant(P<0.05).The oxygen inhalation time,ventilation time,ICU stay time and total hos

关 键 词：新生儿呼吸窘迫综合征 气管插管-肺表面活性物质-拔管后经鼻持续气道正压通气 气管插管 肺功能 动脉血气 

分 类 号：R655.3[医药卫生—外科学]