Silverman Anderson评分在早期处理早产儿呼吸窘迫综合征时应用价值

Silverman Anderson score applying in preterm infants with respiratory distress syndrome

【目的】评价Silverman Anderson(SA)评分在早期处理呼吸窘迫综合征(respiratory distress syndrome,RDS)早产儿时的应用价值。【方法】按照呼吸支持开始前SA评分分值将130例RDS患儿分为轻度(3～5分)、中度(6～7分)和重度(8～10分)三组,将三组患儿的呼吸支持治疗前、治疗初的有关指标进行比较。【结果】1)轻、中和重度RDS三组之间心率(F=17.792)、呼吸次数(F=8.990)、平均动脉压(F=8.677)、吸入氧浓度(F=69.187)和氧合指数(F=50.807)比较差异均有高度统计学意义(P<0.01),各组之间数值两两比较差异也均有统计学意义(P<0.05),心率、呼吸次数和吸入氧浓度变化呈增加趋势,平均动脉压和氧合指数变化呈降低趋势;2)轻度组和中度组之间NCPAP压力比较差异有统计学意义(F=83.216,P=0.000),中度组的压力显著增高;3)轻、中、重度RDS三组间胸部X线片RDS分级(χ2=33.24)、NCPAP治疗成功例数及需要气管插管机械通气例数(χ2=62.62)比较差异均有统计学意义(P值均=0.000);4)NCPAP治疗成功与失败的SA分值比较差异有统计学意义(F=13.404,P=0.001)。【结论】SA评分可以比较客观地反映RDS患儿的呼吸窘迫程度和病情的严重程度,有利于临床医师在床边客观快速评估患儿病情,及时作出正确的处理措施,提高RDS的救治质量。

【Objective】 To understand the significance of Silverman anderson score for assessing the severity extent of preterm infants with respiratory distress syndrome（RDS）.【Methods】 A total of 130 preterm infants with respiratory distress syndrome were divided into 3 groups according to the Silverman Anderson（SA）score：mild group（3~5 scores）,moderate group（6~7 scores） and severite group（8~10 scores）.The difference of respiratory rates（RR）,heart rates（HR）,mean blood pressure（MBP）,Fraction of inspired oxygen（FiO2）,the pressure of NCPAP,X-ray grading of RDS,the number of NCPAP success and surporting by endotracheal intubation,SA value of NCPAP success and failure in each group were compared.【Results】 1）There were statistically significant differences in RR（F=8.990）,HR（F=17.792）,MBP（F=8.677）,FiO2（F=69.187） and oxygenation index（F=50.807） among the group of the mild,moderate and severite group（all P0.01）.2）There were statistically significant differences in the pressure of NCPAP between the mild and moderate group（F=83.216,P=0.000）.The pressure of the mild was higher than that of the moderate group.3）There were statistically significant differences in the X-ray grading of RDS（χ2=33.24）,the number of NCPAP success and surporting by endotracheal intubation（χ2=62.62） among the three groups（all P=0.000）.4）There was statistically significant differences in the SA value between the NCPAP success and failure（F=13.404,P=0.001）.【Conclusions】 SA score can objectively reflect the severity extent of preterm infants with RDS.It might help the clinicians to rapidly assess the severity extent of the infants and give appropriate measures to the infants in the ward.So it might improve the quality of treatment of RDS.