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目的:通过对比不同时段应用肺表面活性物质(PS,商品名:固尔苏)联合经鼻持续气道正压通气(NCPAP)治疗胎龄≤32周新生儿呼吸窘迫综合征(NRDS)的疗效差异。方法:将2011年5月~2013年4月高州市人民医院新生儿科收治的胎龄≤32周、确诊为NRDS的67例早产儿,按照PS的给予时间不同进行分组,观察组31例为在本院产科出生的早产儿,出生后1 h内在本院产房或手术室内给药;对照组36例为出生后6 h内由外院转诊我院新生儿科的早产儿,转至新生儿病房后即在新生儿病房内给药。两组患儿给药后均接NCPAP辅助呼吸,比较两组患儿用药后的临床症状、胸片、动脉血气等的变化程度,以及NCPAP辅助通气时间、上机率、病死率、并发症等方面的差异。结果:观察组临床症状、胸片及动脉血气得到较快改善,与对照组差异有统计学意义;观察组NCPAP辅助通气时间相对较短,上机率少,但差异无统计学意义;两组患儿病死率及并发症的发生率差异无统计学意义。结论:产房或手术室内极早期应用固尔苏可明显改善患儿呼吸功能,为NRDS患儿的后续治疗提供有利前提。
OBJECTIVE: To compare the therapeutic effect of nasal continuous positive airway pressure (NCPAP) and pulmonary surfactant (PS) on the neonatal respiratory distress syndrome (NRDS) at gestational age ≤32 weeks difference. Methods: From May 2011 to April 2013, 67 neonates with gestational age ≤32 weeks who were admitted to neonatology department of Gaozhou People’s Hospital were divided into two groups according to the time of PS administration. The observation group was 31 The obstetric-born preterm infants in our hospital were administrated in the delivery room or operation room within 1 h after birth. In the control group, 36 patients were referred to the neonatology department within 6 h after birth and transferred to the neonatal ward That is administered in neonatal wards. The two groups of children received NCPAP assisted breathing after administration. The clinical symptoms, chest X-ray, arterial blood gas and other changes in the two groups were compared, as well as the NCPAP-assisted ventilation time, the upper probability, fatality rate, complications and so on The difference. Results: The clinical symptoms, chest X-ray and arterial blood gas of the observation group were improved rapidly with significant difference from the control group. The NCPAP-assisted ventilation time in the observation group was relatively short and the upper probability was low, but the difference was not statistically significant. There was no significant difference in the incidence of child mortality and complications. Conclusion: The extremely early application of Gluczosin in the labor room or operation room can significantly improve the respiratory function in children, providing favorable precondition for the follow-up treatment of children with NRDS.