肺表面活性物质及鼻塞式CPAP早产儿肺透明膜病的治疗探讨

Investigation of nasal continuous positive airway pressure and surfactant on preterm infants with hyanline menbrane disease

[目的]评价鼻塞式持续气道正压(continuouspositiveairwaypressure,CPAP)加肺表面活性物质(curosurf)对早产儿肺透明膜病的治疗作用,并与常规的机械通气做比较。[方法]CPAP组27例患肺透明膜病的早产儿经气管内滴入curosurf100mg/(kg·dose),然后拔管予鼻塞式CPAP呼吸支持治疗,并与25例常规的机械通气患儿进行比较,指标包括患儿的临床症状、体征及血气变化、并发症、住院时间以及住院费用。[结果]治疗后1h,患儿症状体征明显好转,6、12及24h,两组患儿的血气较治疗前显著改善,两组比较差异无显著性。而CPAP组肺部感染及慢性肺疾病的发生率明显低于机械通气组,CPAP组的氧疗及住院时间明显少于机械通气组,而且住院费用也较低。[结论]鼻塞式CPAP及肺表面活性物质能有效地治疗早产儿肺透明膜病,与常规机械通气比较,具有治疗效果好、并发症少、住院时间短、住院费用少等特点。

[Objective] To valuate the effect of nasal continuous positive airway pressure(CPAP) and surfactant (curosurf) on preterm infants with hyanline menbrane disease,and compare with conventional ventilation. [Methods] 27 cases with hyanline membrane disease were given curosurf by intratracheal [100 mg/(kg·dose)] , then extubated to nasal CPAP, parameters included blood gas after treatment, complications, hospitalization and fee were compared with 25 cases treated with surfactant and conventional ventilation. [Results] Blood gases improved by the time of 6, 12,24 hours after treatment in the two groups. There was not significant difference between the two groups. The rates of lung infection and chronic lung disease in CPAP group were lower than those of conventional ventilation group, the duration in oxygen and hospitalization were also shorter in CPAP group than in conventional ventilation group, and the fee in CPAP group was lower than that of conventional ventilation group, there was significant differences between the two groups. [Conclusion] Hyanline membrane disease are improved after treating by nasal CPAP and surfactant, less babies have repiratory infection and chronic lung disease in CPAP group compared with conventional ventilation, and the duration of oxygenation and hospitalization in CPAP group are also shorter than conventional ventilation group.