早期应用肺表面活性物质联合NCPAP防治早产儿呼吸窘迫综合征的随访研究

目的:探讨应用肺表面活性物质(PS)联合NCPAP预防与治疗早产儿呼吸窘迫综合征(RDS)的近期预后。方法:40例胎龄<34周、出生体重<2 000 g的早产儿分为预防组和治疗组各20例,预防组为应用PS治疗前未出现呼吸窘迫症状、胸片无RDS改变,治疗组为治疗前出现呼吸窘迫症状、胸片提示有不同程度RDS改变,两组均联合应用NCPAP。结果:预防组NCPAP使用时间、用氧时间显著少于治疗组,差异有统计学意义(P<0.05),住院时间平均缩短5天(P>0.05),而并发症的发生、生后6个月内呼吸道疾病的发生频率、因呼吸道疾病再住院的频率及矫正年龄6个月的智测差异无统计学意义(P>0.05)。结论:生后早期应用肺表面活性物质联合NCPAP可以减少NCPAP使用时间、用氧时间、住院时间,对并发症的发生、生后早期呼吸道疾病的发生频率、因呼吸道疾病再住院的频率及智力发育无显著影响。

Follow-up study on early application of pulmonary surfactant combined with NCPAP for prevention and treatment of preterm respiratory distress syndrome

Objective:To explore short-term prognosis of application of pulmonary surfactant(PS) combined with nasal continuous positive airway pressure(NCPAP) for prevention and treatment of preterm respiratory distress syndrome(RDS).Methods:Forty premature infants of gestational week<34 week,birth weight<2 000 g were divided into prevention group and treatment group,20 premature infants in each group.Respiratory distress didn't occur in the premature infants in prevention group,no RDS change was found by chest radiography;the premature infants in the two groups were treated with NCPAP.Results:The application time of NCPAP and usage time of oxygen in prevention group were statistically significantly less than those in treatment group(P<0.05).The average duration time of hospitalization shortened by five days(P>0.05).There was no statistically significant difference in the incidence rates of complications,respiratory diseases within six months after birth,frequency of re-admission because of respiratory diseases,and developmental quotient(DQ) at 6 months of the corrected age(P>0.05).Conclusion:Early application of PS combined with NCPAP can reduce the application time of NCPAP and usage time of oxygen and duration time of hospitalization,but the method has no significant effect on complications,frequencies of early respitatory diseases and re-admission because of respiratory diseases,and mental development.