空气鼻塞持续正压通气在早产儿肺透明膜病中的应用

目的探讨空气鼻塞持续正压通气(nCPAP)在早产儿肺透明膜病(HMD)的临床应用效果。方法选择35例Ⅰ～Ⅱ期HMD早产儿,有经济条件使用肺表面活性物质(PS)的患儿气管内注入PS后随机分入空气nCPAP组(气源为空气)或氧气nCPAP组(气源为浓度30%～50%的氧气)治疗;无经济条件使用PS的患儿使用沐舒坦的同时随机分入空气nCPAP组或氧气nCPAP组治疗,观察治疗后临床症状、血气指标、胸部X线的变化。结果空气nCPAP组与氧气nCPAP组治疗后呼吸困难、动脉血气均明显改善,两组有效率分别为78.9%、81.2%,呼吸困难缓解时间、呼吸支持时间无显著差异(p>0.05)。结论空气nCPAP应用于Ⅰ～Ⅱ期HMD的治疗能达到与氧气nCPAP类似的效果,可以显著减少早产儿用氧。

AIR NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE VENTILATION IN TREATMENT OF PRETERM INFANTS WITH HYALINE MEMBRANE DISEASE

Objective To investigate the efficacy of the air nasal continuous positive airway pressure(nCPAP)ventilation in preterm infants with hyaline membrane disease(HMD).Methods 35 preterm infants with stage Ⅰ~Ⅱ HMD: tracheal inject the PS who′s economic conditions were permited to use PS,then were randomized to two groups:air nCPAP(gas source was air)and oxygen nCPAP(gas source was oxygen of concentration from 30% to 50%) groups;use Mucosolvan(MU) who′s economic conditions were not permited to use PS,then were randomized to air nCPAP and oxygen nCPAP groups,clinical symptoms,blood gas analysis,chest X-ray changes were observed after treatment. Results After treatment,difficult breathing and arterial blood gases of both groups were significantly improved,the efficiency of the two groups were 78.9% and 81.3%,dyspnea time and respiratory support time had no significantly difference(p>0.05). Conclusion Air nCPAP used in the treatment of stage Ⅰ~Ⅱ HMD will achieve similar effect of oxygen nCPAP,and can be significantly reduced oxygen used in preterm infants.