应用肺表面活性物质联合NCPAP治疗早产儿呼吸窘迫综合征的对照研究

Randomized controlled trial on treatment of respiratory distress syndrome with preterm infants by pulmonary surfactant combined with nasal continuous positive airways pressure

目的探讨应用肺表面活性物质(PS)联合NCPAP治疗早产儿呼吸窘迫综合征(RDS)的效果。方法将82例呼吸窘迫综合征的早产儿随机分为两组,观察组早期给予气管滴注肺表面活性物质,随后立即进行NCPAP治疗;对照组不予肺表面活性物质处理,比较两组患儿治疗效果、住院时间、氧疗时间、机械通气使用以及并发症等情况。结果两组患儿治疗后血气结果较治疗前有显著改善,差异有统计学意义(P<0.05);观察组患儿的机械通气使用情况、呼吸机相关肺炎的发生率、氧疗时间以及住院时间均较对照组低,差异有统计学意义(P<0.05)。结论早期应用PS联合NCPAP是治疗早产儿RDS的有效方式,能快速有效地改善肺功能,缩短氧疗时间及住院时间,减少相关并发症的发生。

Objective To evaluate the therapeutic effect of pulmonary surfactant administration combined with nasal continuous positive airways pressure in preterm infants with neonatal respiratory distress syndrome （NRDS）. Methods A randomized control trial was conducted in 82 preterm infants with NRDS, which were randomized to the observation group （ received pulmonary surfactant combined with NCPAP） and control group （without pulmonary surfactant）. Treatment effect and group comparisons were made on the measures of days of staying in the intensive care unit, time receiving oxygen therapy, undergoing mechanical ventilation and complication. Results Blood gas improved significantly after treatment in the two groups （ P 〈0. 05 ）. The need for mechanical ventilation, incidence of ventilatorassociated pneumonia , time receiving oxygen therapy, and days of staying in the intensive care unit were less in the observation group than those in the control group （ P 〈 0. 05 ）. Conclusions The early application of NCPAP after pulmonary surfactant administration for preterm infants with RDS is beneficial to improve therapeutic effect.