固尔苏治疗新生儿呼吸窘迫综合征的护理

Nursing about treatment of neonatal respiratory distress syndrom (NRDS) by surfactant

目的 :总结 9例新生儿呼吸窘迫综合征 (NRDS)患儿运用肺表面活性物质 (PS)固尔苏的护理体会。方法 :为 9例NRDS患儿使用固尔苏 ,用时采用左侧位、右侧位、仰卧位 3种不同体位经气管插管匀速注入 ,每次注入后用气囊加压 ,给氧 1～ 2min ,并在用药前 5min、用药后 30min及 6h分别进行血气监测 ,用药前后摄胸片对比观察。结果 :9例患儿用药后 30min～2h呼吸困难均改善 ,SaO2 升高达 90 %以上 ,胸片示肺野透视度明显改善。结论 :掌握好给药时机及给药前的准备非常重要 ,给药时确认患儿气管插管位置 ,采用正确的体位将固尔苏注入气管插管内 ,使药物在肺部均匀分布是保证治疗成功的关键。同时 ,需严密观察患儿生命体征和血氧饱和度的变化 ,加强呼吸道管理 ,严格无菌操作 。

Objective:The author had draw up nursing experiences about treatment of NRDS by pulmonary surfactant.Method:9 cases NRDS who had received surfactant accepted left,lateral posture,right lateral posture,supine posture, received trachea intubation and sac pressure oxygen inhalation,for 1～2 minutes,then X-ray at 5min before medication of surfactant,30min after medication.Result:9 cases all improved in dyspnea,in 30min～2hrs after medication,SaO 2 reached above 90%.X-ray show improvement in pulmonary lucency.Conclusion:Medication time preparation correct intubation technique are all important,we should also pay attention to children's life sign,SaO 2,try to reduce infection and complication.