经鼻持续气道正压通气与肺表面活性物质预防新生儿呼吸窘迫综合征的疗效对比

Nasal continuous positive airway pressure versus pulmonary surfactant in prevention of neonatal respiratory distress syndrome

目的比较经鼻持续气道正压通气(nasal continuous positive airway pressure,nCPAP)与肺表面活性物质(pulmonary surfactant,PS)对新生儿呼吸窘迫综合征的预防性应用。方法将58例高危新生儿随机分为两组,nCPAP组30例,生后2h内预防性应用nCPAP,PS组28例,生后2 h内预防性应用PS。结果新生儿呼吸窘迫综合征的发生率、病死率,气管插管机械通气的使用率组间比较差异均无统计学意义;气管插管机械通气时间及氧气使用时间组间比较差异无统计学意义;nCPAP组气胸的发生率较PS组高;其他临床并发症发生率组间比较差异无统计学意义。结论早期nCPAP的应用是预防新生儿呼吸窘迫综合征的另一良好选择,但需重视并积极预防nCPAP导致的气胸。

Objective To compare the efficacy of nasal continuous positive airway pressure （nCPAP） and pulmonary surfactant （PS） in prevention of neonatal respiratory distress syndrome （NRDS）. Methods Fifty eight high risk neonates were randomly assigned to two groups： within 2 h after birth 30 neonates received prophylactic application of nCPAP （ nCPAP group） , 28 neonates received prophylactic application of pulmonary surfactant （PS group）. Results There was no significant difference in death rate and incidence of NRDS between two groups. No significant difference was found in time duration of mechanical ventilation and total time of oxygen intake between two groups. The incidence of pneumothorax in nCPAP group was higher than that in PS group; there was no significant difference in other complications between two groups. Conclusion Early application of nCPAP is an alternative choice for preventing NRDS in high risk neonates, but caution should be taken for possible occurrence of pneumothorax caused by nCPAP.