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目的探讨早期经鼻持续气道正压通气(nCPAP)联合大剂量沐舒坦治疗在30～34周早产儿呼吸窘迫综合征(NRDS)的预防作用。方法 69例胎龄在30～34周的早产儿随机分为治疗组和对照组。治疗组36例患儿在生后60min内无论有无缺氧均予nCPAP进行呼吸管理,同时行大剂量沐舒坦静脉注射;对照组33例患儿按以往常规治疗,观察两组患儿RDS的发生率、机械通气以及外源性肺表面活性物质(PS)的使用率。结果治疗组RDS的发生率为33.33%,明显低于对照组57.58%(P<0.05)。Ⅰ-Ⅱ级RDS的发生率,两组比较差异有统计学意义(P<0.05);Ⅲ-Ⅳ级两组比较差异无统计学意义(P>0.05)。治疗组生后72h内机械通气率25.00%,对照组51.52%,两组差异有统计学意义(P<0.05)。结论 nCPAP是一种无创伤性技术,早期应用nCPAP联合大剂量沐舒坦静脉注射,对NRDS有一定的预防作用,能减少外源性PS的应用以及减少机械通气需要。
Objective To investigate the preventive effects of early nasal continuous positive airway pressure (nCPAP) combined with high-dose ambroxol on respiratory distress syndrome (NRDS) in preterm infants of 30 to 34 weeks. Methods 69 cases of gestational age 30 to 34 weeks premature children were randomly divided into treatment group and control group. Thirty-six children in the treatment group received nCPAP for respiratory management within 60 minutes after birth, and were given high-dose ambroxol intravenously. In the control group, 33 children were treated by routine conventional therapy and the RDS Incidence, mechanical ventilation, and exogenous pulmonary surfactant (PS) usage. Results The incidence of RDS in the treatment group was 33.33%, which was significantly lower than that in the control group (57.58%, P <0.05). The incidence of grade I-II RDS was significantly different between the two groups (P <0.05). There was no significant difference between the two groups (P> 0.05). The rate of mechanical ventilation in the treatment group within 72 hours after birth was 25.00%, while that in the control group was 51.52%. There was significant difference between the two groups (P <0.05). Conclusion nCPAP is a noninvasive technique. Early application of nCPAP in combination with high-dose ambroxol could prevent NRDS. It can reduce the application of exogenous PS and reduce the need of mechanical ventilation.