肺表面活性物质联合正压通气治疗新生儿呼吸窘迫综合征的临床研究

Pulmonary surfactant combined positive airway pressure in the treatment of neonatal respiratory distress syndrome

目的探讨肺表面活性物质（PS）联合鼻塞持续气道正压通气（NCPAP）治疗新生儿呼吸窘迫综合征的方法和疗效，为临床治疗提供参考。方法将我院2008年2月至2011年2月收治的120例新生儿呼吸窘迫综合征患者采用随机抽样法分为两组，对照组60例，行NCPAP治疗。实验组60例，在NCPAP治疗的基础联合PS治疗。治疗后随访10—15d，观察两组患者治疗的临床疗效和PaO2（mmHg）、PCO2（mmHg）、pH值等血气变化。结果随访期间两组内相比，治疗后患者的血气分析均优于治疗前（P〈0．05）；两组间相比，治疗72h后实验组患者的PaO2为（85．7±10．3）mmHg，PCO2为（40．8圭7．6）mmHg，pH为（7．38±0．06），均优于对照组，差异均有统计学意义（P〈0．05）；两组间相比，实验组有效率为95％，高于对照组的80％，差异有统计学意义（P〈0．05）。结论早期行PS联合NCPAP治疗新生儿呼吸窘迫综合征，可显著增强疗效，改善患者的血气指标，有利于提高患者的生活质量，值得在临床中推广使用。

Objective To evaluate the effect of pulmonary surfactant （PS） combined nasal continuous positive airway pressure （NCPAP） in the treatment of neonatal respiratory distress syndrome. Methods 120 cases with neonatal respiratory distress syndrome were divided into two groups randomly from February 2008 to February 2011, 60 patients in the control group, were treated with NCPAP only. 60 patients in experimental group, were treated with NCPAP and PS. The clinical efficacy and PaO2 （mmHg）, PCO2 （mmHg）, pH value and other blood gas changes were observed and had been followed up for 10-15 d. Results The patient＇s blood gas analysis after treatment were better than that before treatment in two groups （P〈0.05）; PaO2 of （85.7±10.3） mmHg, PCO2 of （40.8±7.6） mmHg, pH of （7.38±0.06） in experimental group were significantly better than those in control group after 72 h treatment. （P〈0.05）; the total effective rate of 95% in experimental group was significantly higher than control group of 80% （P〈0.05）. Conclusion Early-line treatment of PS combined NCPAP for neonatal respiratory distress syndrome, can significantly enhance efficacy and improve the patient＇s blood gas analysis, help to improve the quality of life of patients.