外源性表面活性物质联合鼻塞持续气道正压治疗NRDS的临床疗效

目的:探讨外源性表面活性物质(PS)联合鼻塞持续气道正压(NCPAP)治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法:2009年9月-2010年9月笔者在重庆儿童医院进修期间收治28例新生儿呼吸窘迫综合征患儿,给予PS气管内滴入联合NCPAP治疗,观察患儿吸气三凹征和呼吸呻吟情况,监测入院时与治疗后30min、2h、6h和12h呼吸频率、动脉血气分析、氧合指数(PaO2/FiO2),入院24h、72h胸部X片,记录相应并发症。结果:治愈27例(96.4%),死亡1例(3.6%),经治疗后患儿吸气三凹征和呼吸呻吟声消失,30min后动脉血氧分压(PaO2)开始上升,与治疗前比较无明显统计学差异(P>0.05),2h后明显升高,与治疗前比较差异有统计学意义(P<0.05),19例患儿胸部X片在入院24h后明显改善,8例72h后明显改善,1例无改善;颅内出血1例(3.6%)。结论:外源性PS联合NCPAP治疗可有效改善NRDS患儿肺部气体交换和氧合,提高NRDS患儿生存率,减少有创通气及缺氧所致并发症。

Exogenous Pulmonary Surfactant Combined Nasal Continuous Positive Airway Pressure on Treatment of NRDS

Objective：To explore the clinical efficacy of pulmonary surfactant combined nasal continuous positive airway pressure（NCPAP）treatment of neonatal respiratory distress syndrome.Methods：28 cases patients with neonatal respiratory distress syndrome were treated by PS combined NCPAP from September 2009 to September 2010.Observed the respiratory symptoms and monitored the admission and respiratory rate,arterial blood gas analysis,oxygenation index（PaO2/FiO2）after treatment of 30min,2h,6h and 12h.At the same time,Recorded the chest X ray after treatment of 24h,72h and the complications.Results：27 cases were cured（96.4%）,1 patient died（3.6%）.Respiratory symptoms three depressions disappear moans after treatment,the arterial partial pressure of oxygen（PaO2）began to increase 30min after treatment,there was no significant statistical difference compared with before treatment（P0.05）,significantly increased 2h after treatment,compared with before was significantly（P0.05）,19Patients＇ Chest X ray significantly improved after 24h of admission,8 patients improved significantly after the 72h,1 case was no improvement,1 case had intracranial hemorrhage（3.6%）.Conclusion：PS combined NCPAP can effectively improve pulmonary gas exchange,oxygenation and survival in children with NRDS.