| 摘要: |
| 目的观察肺表面活性物质（PS）联合双相呼吸道正压通气（BIPAP）治疗新生儿呼吸窘迫综合征（NRDS）的临床疗效。方法86例行BIPAP的NRDS患儿根据是否使用PS分为对照组（35例）和观察组（51例），比较两组治疗前及治疗24、48h后的PaO2、氧和指数[PaO2/吸入氧浓度（FiO2）]、pH值、PaCO2、PaCO2与肺泡氧分压比值（PaO2/PAO2）、机械通气参数及存活率、机械通气时间、住院天数。结果观察组在治疗后各时间点的PaO2、pH、PaO2/FiO2、PaO2/PAO2均较对照组升高，PaCO2降低（均P＜0.05）。观察组在治疗后各时间点的FiO2、MAP、PEEP均较治疗前及对照组明显降低，差异均有统计学意义（均P＜0.05）。治疗后，对照组FiO2、MAP在24、48h时均较治疗前降低（均P＜0.05）；对照组PEEP治疗后较治疗前呈升高趋势（均P＜0.05）。观察组机械通气时间短于对照组，差异有统计学意义（P＜0.05）。观察组的存活率为94.1%，高于对照组的85.7%，观察组用氧治疗时间、住院时间均少于对照组，差异均有统计学意义（均P＜0.01）。结论PS联合BIPAP治疗NRDS，可有效改善患儿的肺通气功能，降低患儿病死率，减少住院时间，改善预后。 |
| 关键词: 肺表面活性物质 双相呼吸道正压通气 新生儿呼吸窘迫综合征 |
| DOI：10.12056/j.issn.1006-2785.2017.39.7.2016-843 |
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| Clinical efficacy of pulmonary surfactant combined with biphasic positive airway pressure ventilation in treatment of neonatal respiratory distress syndrome |
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JIN Weimin, YANG Xiulu, ZHENG Ge, HUANG Yumao, CHEN Xiang
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the Third Affiliated Hospital of Wenzhou Medical University
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| Abstract: |
| Objective To assess the clinical efficacy of pulmonary surfactant (PS) combined with biphasic positive airway pressure(BIPAP) in treatment of neonatal respiratory distress syndrome (NRDS). Methods Eighty six NRDS children treated with BIPAP were assigned to two groups: 51 cases received additional administration of PS (study group) and 35 cases had no additional PS treatment (control group). The arterial oxygen tension (PaO2), oxygen index (PaO2/FiO2), pH value, arterial carbon dioxide tension(PaCO2), arterial oxygen and oxygen alveolar partial pressure ratio(PaO2/PAO2), mechanical ventilation parameters, duration of mechanical ventilation, length of hospital stay and the survival rate in two groups were compared. Results After treatment, the PaO2, pH, PaO2/FiO2 and PaO2/PAO2 in study group were higher than those in control group in all time points, and
the PaCO2 was decreased (P＜0.05). The FiO2, MAP and PEEP in study group at all time points after treatment were significantly
lower than those before treatment and control group (P＜0.05). The FiO2 and MAP in control group 24h and 48 h after treatment were lower, and PEEP was higher than those before treatment (both P＜0.05). The mechanical ventilation time in study group was significantly shorter than that in the control group (P＜0.05). The study group had significantly shorter time of oxygen therapy and shorter length of hospital stay than the control group (P＜0.01). The survival rate in study group was significantly higher than that of the control group (94.1% vs 85.7%, P＜0.05). Conclusion The administration of pulmonary surfactant combined with biphasic positive airway pressure ventilation can effectively improve pulmonary function, shorten hospitalization time, reduce mortality and improve the prognosis in children with NRDS. |
| Key words: Pulmonary Surfactant Biphasic positive airway pressure ventilation Neonatal Respiratory Distress SSyn- drome |
