摘要
目的探讨气管插管-给予肺表面活性物质(PS)-拔管后经鼻持续正压通气(nCPAP)模式治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效情况。方法选取2006年6月—2012年6月我院儿科NICU收治的82例NRDS患儿为本研究对象,分为观察组51例和对照组31例。观察组应用气管插管-给予PS-拔管后使用nCPAP治疗模式,对照组仅给予nCPAP治疗模式。对两组治疗前后的主要血气指标、气体交换常用指标、nCPAP辅助通气治疗后24 h所需压力、nCPAP辅助通气治疗时间、用氧治疗时间、总住院时间、病情无好转或恶化的比例等进行比较。结果两组治疗前血浆酸碱度(pH)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、动脉血氧分压与吸入氧浓度的比值(PaO2/FiO2)、动脉血氧分压与肺泡氧分压比值(PaO2/PAO2)各项指标比较,差异均无统计学意义(P>0.05);治疗后6 h、24 h、48 h的pH、PaO2、PaCO2、PaO2/FiO2、PaO2/PAO2比较,差异均有统计学意义(P<0.05)。两组治疗后24 h nCPAP所需压力、nCPAP辅助通气治疗时间比较,差异均有统计学意义(P<0.05)。两组用氧治疗时间和住院时间比较,差异均有统计学意义(P<0.05)。观察组病情无好转或恶化的患儿有11例(21.6%),对照组有17例(54.8%),差异有统计学意义(P<0.05)。结论气管插管-PS-拔管后nCPAP治疗模式应用于NRDS的治疗,可迅速改善患儿的通气和换气功能,改善患儿的缺氧与代谢性和呼吸性酸中毒状态,从而大大提高了抢救的成功率,缩短住院时间,安全且疗效显著,值得在临床上大力推广应用。
Objective To investigate the clinical effect of tracheal intubation plus pulmonary surfactant （PS） adminis- tration and nasal continuous positive airway pressure （nCPAP） after extubation for neonate with respiratory distress syndrome （NRDS） . Methods The NRDS patients who were admitted to Neonatal Intensive Care Unit of Xiamen Hospital of Traditional Chinese Medicine, from June 2006 to June 2012, were divided as trial group （ n = 51 ） and control group （ n = 31 ） . The patients in the trial group were given the therapy of tracheal intubation plus PS administration and nCPAP after extubation, and those in the control group were given nCPAP only. The data before and after the treatment of arterial blood gas analysis results, parameters of gas exchanges, pressure needed for nCPAP 24 - h after mechanical ventilation, time of nCPAP, time of oxygen therapy, total time of hospital stay, and the changes of condition were compared between the two groups. Results Before the treatment no sig- nificant differences were found in pH, PaO2, PaCO2, PaO2/FiO2 , and PaO2/PAO2 between the two groups （P 〉0. 05） ; how- ever, 6 h, 24 h, and 48 h after the treatment there were significant differences in pH, PaO2, PaCO2 PaO2/FiO2, and PaO2/ PAO2 （ P 〈0. 05 ） . And the significant differences were found between the two groups in pressure needed for nCPAP 24 - h after mechanical ventilation, time of nCPAP, time of oxygen therapy, and total time of hospitalization （ P 〈 0. 05 ） . There were 11 （21.6%） patients in the trial group and 17 （54. 8% ） in the control group whose condition had no improvement or deterioration （P 〈 0. 05 ） . Conclusion The application of tracheal intubation plus PS administration and nCPAP after extubation for neonate with NRDS can rapidly improve the ventilation and significantly rectify anoxia and acidosis. So it can greatly raise the success rate for rescuing the patient and also reduce the length of hospitalization. It is Safe and highly effective, and thus worthy of populariza- tion clinically.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第10期1134-1136,共3页
Chinese General Practice
关键词
新生儿呼吸窘迫综合征
肺表面活性物质
经鼻持续正压通气
治疗结果
Neonatal respiratory distress syndrome
Pulmonary surfactant
Nasal continuous positive airway pres- sure
Treatment outcome
