配合鼻塞持续气道正压通气防治新生儿ARDS的临床分析

目的观察应用布地奈德、固尔苏配合鼻塞持续气道正压通气防治新生儿呼吸窘迫综合征的临床疗效。方法将2006年12月至2009年2月本院及市中医院妇产科分娩的胎龄在28-32周，无产前、产时窒息、生后一小时内转入我院的早产儿68例随机分成两组。治疗组34例：用布地奈德0.25mg／kg和固尔苏100mg／kg混合液气管内滴入配合鼻塞持续气道正压通气；对照组34例：用固尔苏100mg／kg混合液气管内滴人配合鼻塞持续气道正压通气。结果治疗组34例中0例发生新生儿呼吸窘迫综合征，3例改用机械通气，l例气管内给药2次。对照组34例中4例发生新生儿呼吸窘迫综合征，10例改用机械通气，8例气管内给药2次。治疗组合并新生儿肺炎6例，对照组合并新生儿肺炎11例，两组新生儿呼吸窘迫综合征发生率、重复用药率、机械通气率、新生儿肺炎发生率之间比较差异有显著性（P〈0.05）。结论布地奈德、固尔苏配合鼻塞持续气道正压通气能有效地防治新生儿呼吸窘迫综合征，并具有氧气调节装置及加温湿化装置，减少机械通气，减少重复用药，减轻病人的负担，减少并发症和后遗症的发生，提高患儿的生存质量。

Study on combining budesonide suspension, pulmonary surfactant curosurf and nasal continuous positive airway pressure in prevention and treatment of respiratory distress syndrome of premature

Objective To evaluate the clinical effect of combining budesonide suspension, pulmonary surfactant curosurf and nasal continuous positive airway pressure in the prevention and treatment of respiratory distress syndrome （NRDS） of prematures. Methods 68 preterm infants（delivered within one hour in Department of Gynaecology and Obstetrics of Jiangyin Hospital of Chinese Medicine） of gestation age between 28 w-32 w and no prenatal and natal asphyxiation, were randomly divided into two groups. Among them, 34 neonates of the treated group were dripped in the mixture of budesonide suspension （0.25mg/Kg） and curesuff （100 mg/kg） through trachea combining with nasal continuous positive airway pressure. Another 34 neonates of the control group were only dripped in curosurf （ 100 mg/kg）. Blood gas analysis was compared before and after the therapy. Pulmonary surfactant curosurf and complication of pneumonia were analyzed. Results In the treated group, no case developed NRDS, 3 cases were changed into mechanical ventilation, and 2 cases were administrated with drug two times. In the control group, 4 cases developed NRDS, 10 cases were changed into mechanical ventilation, and 8 cases were administrated with drug two times. In the treated group, 6 cases had complicated pneumonia, but 11 cases in the control group. There were significantly differences between of the two groups of the incidents of NRDS, repeated administration, mechanical ventilation, and pneumonia （P 〈 0.05）. Conclusion The clinical effect of combining budesonide suspension, pulmonary surfactant curosurf and nasal continuous positive airway pressure in prevention and treatment of NRDS is apparent, which have oxygen control apparatus and warm and humidification regimen apparatus. This regimen for the prevention and treatment has the advantages of lower rate of using mechanical ventilation, repeating administration of pulmonary surfactant and residual and charges. It also can increase the survival quality.