早期应用持续气道正压通气治疗新生儿呼吸窘迫综合征临床观察

目的观察早期应用气管插管一肺表面活性物质注入一快速拔管后给予经鼻持续气道正压通气（intubationsurfactantextubation，INSURE）技术治疗新生儿呼吸窘迫综合征（neonatalrespiratorydistresssyndrome，NRDS）的疗效。方法NRDS患儿52例依据治疗方法不同分为2组，观察组28例均早期应用INSURE技术，对照组24例给予经鼻持续气道正压通气（nasalcontinuouspositiveairwaypressure，nCPAP）治疗。比较2组治疗前及治疗后6、24h时pa（02）、pa（C02）、pa（O2）／吸氧浓度（fractionofinspiration02，Fi02），及nCPAP使用时间与治疗成功率。结果2组治疗6、24h后pa（02）、pa（O2）／FiO2均较治疗前增高（P〈0．05），观察组pa（CO2）较治疗前降低（P〈0．05），对照组pa（CO2）与治疗前比较差异无统计学意义（P〉0．05）；2组治疗后24hpa（0z）、pa（O2）／FiO2及pa（CO2）比较差异有统计学意义（P〈0．05）；观察组nCPAP使用时间较对照组短、治疗成功率较对照组高（P〈0．05）。结论早期应用INSURE技术治疗NRDS可改善患儿通气状况及氧合，缩短ncPAP使用时间，提高治疗成功率。。

Clinical observation of early application of intubation-surfactant-extubation in the treatment of neonatal respiratory distress syndrome

Objective To assess the therapeutic effect of early application of intubation-surfactant-extubation （INSURE） in the treatment of neonatal respiratory distress syndrome （NRDS）. Methods Fifty-two NRDS newborns were divided into two groups according to the treatment methods. Observation group （n=28） was treated with INSURE technique in early stage, and control group was treated with nasal continuous positive airway pressure （nCPAP）. pa（O2 ）, pa（CO2 ）, ratio of pa（O2 ） to fraction of inspiration 02 （FiO2）, nCPAP-use time and success rate were compared between two groups before treatment, and 6 and 24 hours after treatment. Results pa（O2）and pa（02 ）/FiO2 significantly increased in both groups and pa（CO2） significantly decreased in observation group 6 and 24 hours after treatment compared with before treatment （P~0.05）. There was no significant difference in pa（CO2 ） after treatment compared with before treatment in control group （P〈0.05）. There were significant differences in pa（O2）, pa（CO2） and pa（O2）/ FiO2 24 hours after treatment compared with before treatment in both groups （P〈0.05）. Observation group had shorter nCPAP-use time and higher success rate compared with control group （P〈0.05）. Conclusions Early application of INSURE can improve ventilation and oxygenation, shorten nCPAP-use time, and improve success rate for NRDS.