INSurE技术治疗早产儿呼吸窘迫综合征的临床观察

Clinical observation of INSur E technique in the treatment of premature infants with respiratory distress syndrome

目的探讨INSur E技术治疗早产儿呼吸窘迫综合征的临床疗效。方法选取2010年至2011年于我院进行治疗的25例患呼吸窘迫综合征的早产儿为对照组,应用持续正压通气的呼吸支持方法治疗;2012年至2013年23例患呼吸窘迫综合征的早产儿为观察组,采用INSURE技术治疗。比较两组患儿治疗前后动脉血气分析(包括动脉血氧分压Pa O2、二氧化碳分压Pa CO2、氧合指数Pa O2/Fi O2、p H等)改善情况,以及呼吸支持使用时间、氧疗时间、住院时间、并发症等。结果两组治疗后24 h的p H、Pa O2、Pa O2/Fi O2均较治疗前有不同程度上升,Pa CO2均较治疗前有不同程度下降(P<0.05);观察组无创通气时间[(68.8±16.1)h]、氧疗时间[(8.5±3.6)d]、住院时间[(19.8±6.2)d]均优于对照组,且差异有统计学意义(P<0.05);观察组呼吸暂停、BPD发生率、有创通气与病死率均低于对照组(P<0.05)。结论早产儿呼吸窘迫综合征应用INSURE技术进行呼吸支持治疗能够缩短无创通气时间、住院时间,并发症少,且操作方便,安全性高。

Objective To observe the clinical effect of INSURE technique on premature infants with respiratory distress syn- drome（RDC）. Methods Twenty five premature infants with RDS from 2010 to 2011 were selected as control group （conducted CPAP breathing） ; Twenty three premature infants with RDS from 2012 to 2013 were selected as observation group （ conducted INSURE）. The arterial blood gas analysis （including PaO_2, PaCO_2, oxygenation index PaO_2/FiO_2, PH etc. ） before and after treatment, respiratory support the use of time, duration of oxygen therapy, hospitalization time, and rate of complications of the two groups were was compared. Results The 24h pH, PaO_2, PaO_2/FiO_2 were all higher than those before treatment in the two goups, and PaCO_2 decreased, and the differences were all significant （P 〈 0. 05 ）. The noninvasive ventilation time of observa- tion group was （68.8 ±16. 1 ） h, duration of oxygen therapy was （ 8.5± 3.6） d, the hospitalization time was （ 19.8 ± 6. 2） d, which were all superior to those of the control group, and the differences were statistically significant （ P 〈 0. 05 ）. In observation group, the incidence of apnea, BPD, ventilation and mortality were lower than those of the control group （P 〈 0. 05）. Conclu- sion Respiratory support therapy in premature infants with RDS using INSURE technology can shorten the noninvasive ventila- tion time, hospitalization time, complications, and is also convenient and safe.