新生儿呼吸窘迫综合征临床资料分析

目的分析新生儿呼吸窘迫综合征（RDS）的临床特点及肺表面活性物质（PS）替代治疗后的并发症,提高对本病的诊治水平。方法采用前瞻性临床对照研究方法,分析呼吸窘迫综合征患儿临床表现,并将65例RDS患儿分为PS治疗组和对照组,研究两组机械通气的天数、存活率、及并发呼吸机相关性肺炎、颅内出血、肺出血、肺气漏、支气管肺发育不良的发生情况。结果RDS首发症状以呼吸系统为主,发病时间以4-8小时多见。治疗组机械通气的天数缩短[（6.1±4.3）d VS（8.7±5.4）d],存活率由62.96%上升至86.84%,差异具有显著性（P〈0.05）。治疗组肺气漏发生率由33.33%下降至10.53%,呼吸机相关性肺炎发生率由55.56%下降至28.95%,差异有显著意义（P〈0.05）。而颅内出血、肺出血及BPD的发生率无明显变化。产前应用糖皮质激素可以降低RDS的发生率（P〈0.05）。结论PS替代治疗RDS可以明显缩短机械通气天数,提高存活率,降低肺气漏及呼吸机相关性肺炎的发生率。产前应用糖皮质激素可以降低RDS的发生率。

Clinical characteristics of neonatal respiratory syndrome.

Objective： To analyze clinical characteristics of neonatal distress syndrome （NRDS） and study the complication of the NRDS following pulmonary surfactant （PS） replacement therapy in neonates. Methods： Sixtyfive newborns with RDS were assigned into the PS treatment group and the control group. The former , besides the usual treatment for the control group , received PS replacement . The duration of mechanical ventilation , survival rate and incidence of complication, including ventilator associated pneumonia, lung hemorrhage, air leak, intracranial hemorrhage, bronchopulmonary dysplasia （BPD） were compared between the two groups. Results ： There were significant differences in the ventilation time [ （6. 1 ±4. 3 ） d vs （ 8. 7 ± 5.4 ） d ] and survival rate [86. 84% vs 62. 96% ] in the PS treatment group. Compared with the control group, significant differences were noted in the inci- dence of complications between the two groups ： the PS treatment group had lower incidences of air leak and ventilator associated pneumonia [33.33% vs 10. 53% ; 55.56%vs28.95% respectively] （bothP 〈0. 05） . But BPD, intracranial hemorrhage and lung hem- orrhage were no different. Glucocorticoid can reduce the rate of RDS. Conclusion： Mechanical ventilation days could be reduced and the survival rate could be increased by PS replacement therapy in newborns with RDS. PS replacement therapy can decrease the incidence of complications.