肺表面活性物质联合机械通气治疗新生儿呼吸窘迫综合征

The clinical observation of mechanical ventilation combined with pulmonary surfactant in the treatment of neonatal respiratory distress syndrome

目的观察肺表面活性物质联合机械通气治疗新生儿呼吸窘迫综合征的临床疗效。方法选取我院儿童重症监护病房收治的新生儿呼吸窘迫综合征的患者60例。所有患儿在常规治疗的基础上,加用肺表面活性物质联合机械通气进行治疗,观察患儿治疗前后血气分析、呼吸机参数以及临床疗效的变化情况。结果患儿治疗2h、6h、12h的血氧分压分别为(71.38±10.21)mmHg、(75.92±9.76)mmHg、(86.48±10.95)mmHg,明显高于治疗前的(46.19±9.58)mm-Hg,其治疗2h、6h、12h的二氧化碳分压分别为(42.48±6.72)mmHg、(40.37±7.69)mmHg与(38.94±6.82)mmHg,明显低于治疗前的(56.73±6.39)mmHg,且血液pH值较治疗前明显上升,气道峰压、呼气末正压均较治疗前明显下降,差异均有统计学意义(P<0.05)。本组显效56例,有效4例,总有效率100.00%,且治疗过程中,未见心动过缓、呼吸暂停等严重不良反应。结论肺表面活性物质联合机械通气治疗新生儿呼吸窘迫综合征的临床疗效显著,不良反应少,是一种有效、安全性高的治疗方法。

Objective To observe the curative effect of mechanical ventilation combined with pulmonary surfactant in the treatment of neonatal respiratory distress syndrome.Methods 60 children with neonatal respiratory distress syndrome were selected in our hospital,they were received the treatment of mechanical ventilation combined with pulmonary surfactant based on the conventional treatment.The blood gas,ventilator parameters and curative effect were compared before and after treatment.Results The partial pressure of oxygen of the children treated after 2h,6h,12h were（71.38±10.21）mmHg,（75.92±9.76）mmHg and（86.48 ±10.95）mmHg,they were significantly higher than that before treatment.The partial pressure of carbon dioxide were（42.48 ±6.72）mmHg,（40.37±7.69）mmHg and（38.94±6.82） mmHg at the same time point,which were significantly lower than that before treatment.The blood pH increased significantly,while the peak airway pressure,positive end expiratory pressure decreased significantly after treatment.The differences were statistically significant（P〈0.05）.The total efficiency was 100%,no serious adverse reaction such as heartbeat bradycardia and apnea was observed.Conclusion Mechanical ventilation combined with pulmonary surfactant showed significant effect in the treatment of neonatal respiratory distress syndrome,while less adverse reaction.It is a kind of efficient,high security treatment method.