肺表面活性物质及鼻塞CPAP治疗早产儿呼吸窘迫综合征

目的:本研究的目的是评价鼻塞式CPAP加肺表面活性物质对早产儿呼吸窘迫综合征的治疗作用,并与常规的机械通气做比较。方法:17例患呼吸窘迫综合征的早产儿经气管内滴入肺表面活性物质(Exosurf)67.5 mg/kg/dose,然后拔管予鼻塞CPAP呼吸支持治疗,与25例常规的机械通气病例比较两者的病情及血气变化、肺部感染及慢性肺疾病的发生率,氧疗和住院时间以及治愈率。结果:治疗后6、12及24小时,两组患儿的血气较治疗前显著改善,两组比较,无明显差异,而CPAP组肺部感染及慢性肺疾病的发生率明显低于机械通气组,CPAP组的氧疗时间也少于机械通气组,但两者的住院时间无明显差异。结论:鼻塞式CPAP及肺表面活性物质能有效地治疗早产儿肺透明膜病,与常规机械通气比较,具有肺部感染及慢性肺疾病的发生率低,氧疗时间短等优点。

Premature with respiratory distress syndrome treated by pulmonary surfactant and nasal CPAP

Objective: To evaluate the effect of nasal CPAP combined surfactant on neonates with respiratory distress syndrome and compare the effect with conventional ventilation. Methods: 17 babies with respiratory distress syndrome were given exosurf by intraluminal (67.5 mg/kg/dose), then drew tubate to nasal CPAP, blood gase, rates of respiratory infection and chronic lung disease, durations in oxygen and hospitalization were compared between two groups. Results: Arterial partial pressure of oxygen increased, arterial partial pressure of carbondioxide and oxygenation index decresed significantly by the time of 6, 12, 24 hours after treatment in both groups. There were not significant difference between two groups. The rates of respiratory infection and chronic lung disease in CPAP group were less than that of conventional ventilation group, the duration in oxygen was also less in CPAP group than that in conventional ventilation group, there was significant difference between two groups. But there was not significant difference in durations of hospitalization between two groups. Conclusion: Surfactant combined nasal CPAP is a potential efficient therapy to the babies with respiratory distress syndrome, it had lower rates of lung infection and chronic lung disease, fewer duration in oxygen compared with conventional ventilation.