持续正压通气联合珂立苏治疗早产儿呼吸窘迫综合征的临床观察

Clinical study on treating Respiratory distress syndrome of premature infant with CPAP combined with Calsurf for injection

目的探讨持续正压通气（CPAP）联合珂立苏治疗早产儿呼吸窘迫综合征（NRDS）的临床效果。方法选择2010年1月～2013年1月湖北省十堰市人民医院新生儿重症监护室78例NRDS早产儿为研究对象。将其随机分为对照组和研究组，每组各39例，对照组患儿给予CPAP治疗，研究组患儿给予CPAP联合珂立苏治疗。比较分析两组患儿的临床疗效及治疗前后pH、PaO2、PaCO：、Pa02／FiO2等血气指标变化。结果治疗48h后，研究组患儿的总有效率为87．19％，明显高于对照组（76．92％），病死率为5．13％，明显低于对照组（10．26％），差异均有统计学意义（均P〈0．05）。治疗后3、10、24、48h研究组pH、PaO2、PaO2／Fi02明显高于对照组，PaCO2明显低于对照组，差异均有统计学意义（均P〈0．05）。结论珂立苏联合CPAP治疗NRDS的疗效确切，可明显改善临床症状、提高患儿动脉氧分压。

Objective To observe the effect of treating respiratory distress syndrome in premature infant with continuos positive airway pressure （CPAP） combined with Calf Pulmonary Surfactant for injection. Methods 78 prematures with respiratory distress syndrome from January 2010 to January 2013 in the NICU of the People＇s Hospital of Shiyan City in Hubei Province were randomly divided into control group and study group with 39 cases in each group. Patients of the control group were given the treatment of CPAP, and patients of study group were treated with CPAP combined with calf pulmonary surfactant for injections. The clinical effect and blood gas index such as pH, PaO：, PaCO2, PaOJFiO2 before and after treatment of two groups were compared and analyzed. Results 48 hours after treatment, the total effective rate of study group （87.19%） was significantly higher than that of the control group （76.92%）, the difference was statistically significant （P 〈 0.05）; the mortality of study group （5.13%） was significantly lower than that of the control group （10.26%）, the difference was statistically significant （P 〈 0.05）. The pH, PaO2, PaO2/FiO2 of study groups in 3,10,24,48 h after treatment were significantly higher than those of the control group, PaCO2 significantly lower than that of the control group, the differences were statistically significant （all P 〈 0.05）. Conclusion CPAP combined with calf pulmonary surfactant for injection is effective in the treatment of respiretory distress syndrome, can significantly improve the clinical symptoms, improve the arterial oxygen partial pressure of the children