肺表面活性物质治疗新生儿呼吸窘迫综合征的效果观察及护理

Observation and nursing care of neonatal respiratory distress syndrome treated with pulmonary surfactant

目的探讨肺表面活性物质治疗新生儿呼吸窘迫综合征的疗效及相应的护理方法。方法19例确诊为新生儿呼吸窘迫综合征的患儿,经气管插管滴入肺表面活性物质,观察滴入前,用药后30min、1h、8h、24h和3d动脉血PaO2、PaCO2、PaO2/FiO2、pH值和PaO2/PAO2变化,观察用药前后呼吸机参数的变化以及肺部X线表现。结果气管内注入肺表面活性物质1h后动脉血气分析各项指标均明显改善,与用药前比较有显著性差异(P<0.001)。用药1h后除呼吸频率外其余参数均可明显下调,与用药前比较有显著性差异(P<0.001)。气管内滴入肺表面活性物质后12h,16例患儿胸部X片显示肺野透亮度增加,肺下界下降达第7、8后肋间以下。结论早期使用肺表面活性物质可改善新生儿呼吸窘迫综合征患儿肺的顺应性和氧合功能,降低呼吸机参数。治疗过程中恰当的护理对于患儿的康复、减少并发症等具有十分重要的作用。

Objective To explore the effect and nursing care of neonatal respirat ory distrtess syndrome (NRDS) treated with pulmonary surfactant (PS). Methods I n 19 cases, PS was dribbled into the patients through tracheal cannula. Arterial blood gas analysis involving PaO2, PaCO2, PaO2/FiO2 PH and PaO2/PAO2 were detec ted before and after 30 min, 1 h, 8 h, 24 h, 3d tretreatment.The parametes of ar terial parametes of breathing machine and X-ray photographs of the neonates were also observed. Results Comparing with pretreatment, the results of arterial bl ood gas analysis were improved significantly after 1 h treatment(P<0.001). Excep t respiratory rate the parametes of breathibg machine were all adjusted downward s after treatment.The brightness of lung field on X-ray photographs was improve d after PS treatment.The lower edge of the lungs was below the seventh to eighth post-rib in 16 cases out of the neonates. Conclusion The oxygenation function and pulmonary compliance of the lung in NRDS children can be well adjusted downw ards. Appropriate nursing care throughout the course was also very important for the outcome and reducing complication in the children.