肺表面活性物质联合鼻塞式持续气道正压通气治疗早产儿肺透明膜病

Curative effect of nasal continuous positive airway pressure(nCPAP) combined with pulmonary surfactant on preterm infants with hyanline menbrane disease

目的评价鼻塞式持续气道正压通气(nCPAP)加用肺表面活性物质(Curosurf)对早产儿肺透明膜病的治疗作用。方法27例患肺透明膜病的早产儿经气管内滴入Curosurf[100 mg/(kg.次)],然后拔管予nCPAP呼吸支持治疗,作为nCPAP组。25例常规机械通气病例作为对照组,比较两组患儿的临床症状体征、血气变化、并发症、住院时间以及住院费用。结果治疗后1 h,两组患儿症状体征明显好转;6、12及24 h,两组患儿的血气较治疗前显著改善,两组比较,无明显差异;nCPAP组肺部感染及慢性肺疾病的发生率明显低于机械通气组;nCPAP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nCPAP及Curosurf联合应用能有效地治疗早产儿肺透明膜病,与常规机械通气比较,具有肺部感染、慢性肺疾病发生率低,住院时间短,住院费用少等特点。

Objective To evaluate the curative effect of nCPAP combined with pulmonary surfactant （Curosurf） on neonates with hyeline menbrane disease. Methods Twenty-seven cases with hyeline membrane disease who were given Curosurf 1100 mg/（ kg·dose） ] by intratracheal instillation, then extubated to nCPAP were regarded as nCPAP group. Twenty-five cases treated with conventional ventilation combined with pulmonary surfactant served as control group. Blood gas, complications, hospitalization and fee were compared between the two groups. Results Blood gases improved at the time of 6, 1 2, 2 4 hours after treatment in the two groups. There were not significant difference between them. The babies in nCPAP group had significantly less incidence of pulmonary infection and chronic lung disease, less duration of oxygen and hospitalization, and lower fee than those of control group. There were significant differences between the two groups. Conclusion Preterm infants with hyaline membrane disease can achieve the improved prognosis by being managed with nCPAP combined with pulmonary surfactant, which has the advantages of less pulmonary infection and chronic lung disease, less duration of oxygen and hospitalization , and lower fee.