不同呼吸模式对新生儿呼吸窘迫综合症的治疗

Premature Babies with Severe Respiratory Distress Syndrome Treated by Different Modes of Ventilation

目的:评价气管插管IPPV、鼻塞IPPV及鼻塞CPAP呼吸模式联合固尔苏对新生儿严重呼吸窘迫综合症(NRDS)的治疗作用。方法:64例NRDS(Ⅱ、Ⅲ级和Ⅳ级)经气管内给予固尔苏(100 mg/kg)后,给予气管插管IPPV(A组,n=23)、鼻塞IPPV(B组,n=20)、鼻塞CPAP(C组,n=21)进行通气治疗,比较三组血气变化、肺部感染、慢性肺病(CLD)的发生率、氧疗及住院时间。结果:三组治疗后6、12、24 h的血气均明显改善;B组及C组的肺部感染、CLD的发生率和氧疗时间均明显低于A组,P<0.05。三组的住院时间无明显差异。结论:鼻塞IPPV、CPAP联合固尔苏治疗NRDS较常规通气模式有较好的疗效,且肺部感染及慢性肺病发生率低,氧疗时间少。

Objective： To evaluate the effect of the modes of ventilation （nasal IPPV,nasal CPAP and conventional IPPV） combined surfaetant on neonates with respiratory distress syndrome （NRDS）. Methods： 64 babies with NRDS were given curosurf（ 100 mg/kg）, the babies were divided into three groups： A group of 20 babies were extubated to nasal [PPV.B group of 23 babies continued on conventional IPPV and C group of 21 babies were extubated to nasal CPAP. ,Blood gas, rates of respiratory infection and chronic lung disease, durations in oxygen and hospitalization were compared among the three groups. Results： The index of blood gas was better significantly by the time of 6, 12, 24 hours after treatment among the three groups. The rates of respiratory infection, chronic lung disease and the duration in oxygen both in B group and C group were less than those in A group,P 〈 0.05. But there was not significant difference in duration of hospitalization among the three groups. Conclusion： Surfactant combined nasal IPPV and nasal CPAP have potential efficient therapy to the babies with severe respiratory distress syndrome, it had lower rates of lung infection and chronic lung disease, fewer duration in oxygen compared with conventional ventilation.