摘要
目的探讨肺泡表面活性物质(PS)早期干预和治疗性应用对胎龄≤29周呼吸窘迫综合征(RDS)患儿的临床效果,分析二者在用氧时间、死亡率、合并症、并发症等的不同,期望得出治疗胎龄较小RDS患儿最佳应用PS的时机。方法选择2018年8月~2019年8月潍坊市妇幼保健院新生儿科收治的胎龄≤29周新生儿呼吸窘迫综合征(NRDS)患儿为研究对象,应用随机、对照、前瞻性试验方法,研究早期干预组(CPAP+PC组)与治疗性应用组(CPAP+SC组)治疗NRDS的临床疗效,观察两组患儿在使用PS前、使用PS后24h内的动脉血气值、CPAP使用时间、总用氧时间、住院时间、死亡率、主要并发症(BPD、ROP、NEC、颅内出血、肺出血)等。结果早期PS干预组使NRDS患儿需氧量迅速下降,但两组患儿在BPD发病率及死亡率方面无差异(P>0.05);PC组患儿治疗后24h内PaO2和PaO2/FiO2高于SC组,PaCO2低于SC组,差异有显著性(P<0.05);PC组CPAP持续时间、给氧时间短于SC组(P<0.05),住院时间无统计学差异;PC组肺出血、ROP发生率少于SC组(P<0.05);两组NEC、IVH发生率比较,差异无显著性(P>0.05)。结论早期干预性应用肺泡表面活性物质能有效治疗早产儿呼吸窘迫综合征,迅速改善肺泡通气功能,缓解患儿症状,减少用氧时间及并发症,减少住院费用。
Objective To investigate the clinical effects of early intervention and therapeutic application of pulmonary surfactant(PS)on newborn with gestational age≤29w respiratory distress syndrome(RDS),and compare the difference in oxygen using time,mortality,complications,etc,in order to give the best time to apply PS.Methods From August 2018 to August 2019,40 cases of NRDS with gestational age≤29 weeks were enrolled in neonatal department of Weifang Maternal and Child Health Hospital,and divided into two groups.Randomized,controlled and prospective trials were used to compare the clinical efficacy of NRDS in the early intervention group(CPAP+PC group)and the therapeutic application group(CPAP+SC group).The observation time is from birth to hospital discharge.The observations were the arterial blood gas value(before and after PS use),CPAP use time,total oxygen consumption time,hospitalization time,mortality,major complications(BPD,ROP,NEC,intracranial hemorrhage,Pulmonary hemorrhage).The content of the mortality of the two groups,major complications(BPD,ROP,NEC,IVH,pulmonary hemorrhage).Results In the early PS intervention group,the oxygen demand of children with NRDS decreased rapidly,but there was no difference in the incidence and mortality of BPD between the two groups(P>0.05).In the PC group,PaO2 and PaO2/FiO2 within 24 hours after treatment was higher than SC group,PaCO2 was lower than SC group,the difference was statistically significant(P<0.05);PC group uses CPAP and oxygenation time were shorter than SC group(P<0.05);no significant difference in hospitalization time;PC The incidence of pulmonary hemorrhage and ROP was lower than that in the SC group(P<0.05).There was no significant difference in the incidence of NEC and IVH between the two groups(P>0.05).Conclusion Early intervention with PS can effectively alleviate NRDS,rapidly improve alveolar ventilation,relieve symptoms,reduce oxygen using time,complications,and hospital stay.
作者
谢文玉
李忠良
曹小玉
赵明明
XIE Wenyu;LI Zhongliang;CAO Xiaoyu;ZHAO Mingming(Department of Pediatrics,Weifang Medical University,Weifang 261053,China;Department of Pediatrics,Weifang Maternity and Child Care Hospital)
出处
《潍坊医学院学报》
2020年第1期38-40,共3页
Acta Academiae Medicinae Weifang
关键词
新生儿呼吸窘迫综合征
肺泡表面活性物质
持续气道正压
Neonatal respiratory distress syndrome
Pulmonary surfactant
Continuous positive airway pressure
作者简介
谢文玉(1993年~),女,在读硕士研究生。主要研究方向:新生儿;通讯作者:李忠良,E-mail:13396469666@126.com
