循证医学在新生儿呼吸窘迫综合征防治中的应用研究

Evidence-based practices in prophylaxis and management of neonatal respiratory distress syndrome

目的评价现行的降低新生儿呼吸窘迫综合征(NRDS)发生率及严重程度的措施,讨论采用降低NRDS发生率及其严重程度的循证医学方法的必要性与障碍。方法采用了定量与定性相结合的方法,从新生儿重症监护室及产科中抽取人员参加专题小组讨论及接受半结构式访谈。结果降低NRDS发生率及严重程度的措施是产前应用皮质激素、预防性肺表面活性物质(PS)的应用、鼻塞持续气道正压通气(NCPAP)的早期使用、预防早产、早产儿监护及NRDS的早期诊断等。结论系统评价充分说明了循证医学在新生儿急救中很有发展潜力,目前对NRDS的治疗正在发挥积极作用。

Objective To evaluate current practices in reducing incidence and severity of neonatal respiratory distress syndrome （NRDS）, and to discuss the possibility and barriers for carrying out evidence-based practices related to decreasing the incidence and severity of NRDS. Methods The research was a descriptive study, quantitative and qualitative. Participants were selected from NICU and Obstetric Department of Fujian Provincial Maternity and Children＇s Hospital, and they joined in group discussion and semi-structured interview. Results The study showed that the use of antenatal corticosteroids, prophylactic surfactant after birth, nasal continuous positive airway pressure （NCPAP） at early stage, prevention of premature labor, close monitoring of premature infants and early diagnosis of NRDS were the key methods to decrease the incidence and severity of NRDS. Conclusions The clinical guideline based on evidence systematical evaluation shows that evidence-based clinical guideline plays important roles in neonatal resuscitation and NRDS treatment.