牛肺泡表面活性剂联合鼻塞持续气道正压治疗早产儿呼吸窘迫综合征的疗效观察

Retrospective observation of calf pulmonary surfactant combined NCPAP for treating premature neonatal respiratory distress syndrome

目的探讨牛肺泡表面活性剂联合鼻塞持续气道正压（NCPAP）治疗新生儿呼吸窘迫综合征的临床效果。方法选取我科2012年1月至11月我院新生儿科收治的早产儿呼吸窘迫综合征病例80例,分为治疗组40例,对照组40例,2组在一般治疗的基础上,对照组给予NCPAP治疗,治疗组用牛肺泡表面活性剂联合NCPAP治疗,牛肺泡表面活性剂使用剂量70~100 mg·kg-1,经气道内滴入,动态观察使用牛肺泡表面活性剂后0,2,12,24 h患儿的血气分析结果和NCPAP参数调整情况,包括血气分析、吸入氧浓度、呼吸末正压情况,并统计NCPAP通气时间、氧疗时间、住院时间及死亡率。结果治疗组在治疗后2,12和24 h血PaO2、血PH值明显升高,血PaCO2、吸氧浓度和PEEP明显降低,与对照组比较,差异有统计学意义（P〈0.001）。治疗组NCPAP使用时间﹑氧暴露时间﹑住院天数和死亡率低于对照组,2组比较差异有统计学意义（P〈0.001）。结论牛肺泡表面活性剂联合NCPAP治疗新生儿呼吸窘迫综合征效果显著,且价格优惠,值得临床上推广应用。

Objective To evaluate the effect of calf pulmonary surfactant combined nasal continuous positive airway pressure（ NCPAP） on treating neonatal respiratory distress syndrome（ NRDS）. Methods Eighty children with NRDS were equally divided into two groups（ experimental group and control group）. Experimental group were given one dose calf pulmonary surfactant by endotracheal dripping and NCPAP, while control group patients were given NCPAP only. Arterial blood gas index,ventilator parameters,time of NCPAP treatment,time of oxygen therapy,length of hospital stay and mortality between 2 groups were analyzed and compared. Results PaO 2 and arterial PH in experimental group at 2 h,12 h,24 h after treatment are significantly higher than control group,while PaCO 2,FiO 2 and PEEP level are significantly lower than control group（ P 0. 001）. The time of using NCPAP,the oxygendependant time,the length of hospital stay in experimental group were significantly shorter than those in control group（ P 0. 001）. Mortality in experimental group is significantly lower than control group. Conclusion Endotracheal dripping of calf pulmonary surfactant combined with NCPAP is an effective treatment for NRDS.