肺表面活性物质联合新型鼻塞持续气道正压呼吸治疗新生儿肺透明膜病疗效分析

The Effect of Pulmonary Surfactant Joint New Nasal Continuous Positive Airway Pressure Treatment of Neonatal Respiratory Hyaline Membrane Disease

目的探讨肺表面活性物质Curosurf联合新型鼻塞持续气道正压呼吸(NCPAP)治疗新生儿肺透明膜病(HMD)的临床效果。方法将87例HMD患儿随机分为两组,观察组43例患儿经气管内注入Curosurf100mg·kg-1·次-1,然后拔管予NCPAP治疗;对照组44例患儿不用Curosurf治疗,比较两组患儿的临床治疗效果、并发症、住院时间、住院费用等。结果治疗后1h、12h、24h两组患儿的血气结果较治疗前显著改善,差异有统计学意义(P<0.05);两组治疗后比较差异亦有统计学意义(P<0.05)。观察组患儿的高压力、高FiO2及用NCPAP等各项所需时间较对照组明显缩短,差异均有统计学意义(P<0.05)。观察组治愈率为88.4%,对照组为63.6%,两组比较差异有统计学意义(P<0.05)。观察组肺炎的发生率明显低于对照组,差异有统计学意义(P<0.05)。观察组住院费用(18875±639)元,对照组总住院费用(18060±607)元,差异无统计学意义(P>0.05)。观察组住院(16±10)d,对照组(20±11)d,差异有统计学意义(P<0.05)。结论Curosurf联合NCPAP治疗HMD疗效确切,能快速有效地改善HMD的肺换气和通气功能,缩短住院天数及减少机械通气率和肺炎并发症的发生,住院费用没有增加。

Objective To discuss what Pulmonary surfactant on the new nasal continuous positive airway pressure treatment of neonatal respiratory hyaline membrane disease in clinical effects. Methods 87 cases HMD Were randomly divided into two groups, 43 cases of children with hyaline membrane Injected Curosurf （100mg/Kg/rate） by intratracheal instillation, and then treated as extubation to NCPAP group. Curosurf 44 cases without treatment as the control group, two groups were compared clinical effects, complications, hospitalization, hospital costs. Results Blood gases improved at the time of lh, 12h or 24h after treatment in the two groups, the two groups showed significant differences. Observer Group in children with high - pressure, high FiO2 and the time required for NCPAP compared with the control group was significantly shortened, The differences were significant （ P 〈0. 05） ; The cure rate of observer group is 90. 4%, and the cure rate of the control group is 77.7%, the difference between the treatment groups was significant （ P 〈 0.05 ） ; The incidence of pneumonia for Observer Group was significantly lower than the control group, There was significant difference （ P 〈 0.05 ）. Observer Group hospitalization costs 18, 875±639 Yuan. The total hospital costs of control group is 18060 ±607 Yuan, and no significant difference （ P 〉 0. 05 ） ; The hospitalization of observation group is （ 15.6± 9.7） days, significantly shorter than the control group （20. 5± 11.3 ） days, the difference was significant （ P 〈 0. 05）. Conclusion Curosurf joint NCPAP to treat HMD that treatment is effective, which can be quickly and efficiently improve Pulmonary ventilation and ventilatory function of HMD, reduce the number of hospitalization days of mechanical ventilation rate and reduce the incidence of complications and pneumonia, hospital fees had not increased.