珂立苏联合护理干预治疗早产儿呼吸窘迫综合征75例疗效评价

Observation on Efficacy of Calsurf and NCPAP Combined with Nursing Intervention in Treating Preterm Neonatal Respiratory Distress Syndrome

目的探讨注射用牛肺表面活性剂(商品名珂立苏)与鼻塞式持续气道正压通气(NCPAP)联合护理干预治疗早产儿新生儿呼吸窘迫综合征(NRDS)的疗效。方法选择2008年8月至2014年8月收治NRDS早产儿145例,均应用珂立苏与NCPAP联合治疗,依据护理方式将其分为研究组(75例)与对照组(70例)。对照组予以常规护理,研究组在此基础上实施护理干预。结果与对照组比较,研究组6 h血气分析p H、氧分压(Pa O2)、氧合指数(Pa O2/Fi O2)水平无统计学差异(P>0.05),Pa CO2水平呈明显差异(P<0.05);研究组12 h血气分析p H水平无统计学差异(P>0.05),Pa O2,Pa CO2,Pa O2/Fi O2水平均呈明显差异(P<0.05);研究组24 h血气分析p H及Pa O2/Fi O2水平无统计学差异(P>0.05),Pa O2及Pa CO2水平有统计学差异(P<0.05);研究组72 h后呼吸机参数中的呼气末正压、平台压无统计学差异(P>0.05),吸气峰压、平均呼吸道压、潮气量、每分钟通气量均呈明显差异(P<0.05);研究组呼吸困难缓解时间、吸氧时间、NCPAP治疗时间、住院时间均呈明显差异(P<0.05);研究组肺炎发生率、脑白质软化发生率均较低,治愈率则较高(P<0.05)。结论早产儿NRDS应用珂立苏与NCPAP联合治疗期间实施护理干预,不仅有助于症状、体征、患儿治疗时各项临床指标等的改善,还能提高治愈率、降低并发症发生率、改善患儿呼吸状态,效果显著。

Objective To observe the clinical effect of Calsurf （ calf pulmonary surfactant ） and nasal continuous positive airway pressure （ NCPAP ） combined with the nursing intervention in treating preterm neonatal respiratory distress syndrome （ NRDS ） . Methods 145 cases of preterm NRDS in our hospital from August 2008 to August 2014 were selected and treated by the combined therapy of Carlsurf and NCPAP. All cases were divided into the study group （ n=75 ） and the control group （ n=70 ） according to the nursing mode. The control group was given the routine nursing, while on this basis the study group was implemented the nursing intervention. Results The pH, PaO2 and PaO2/FiO2 levels at 6 h blood gas analysis had no statistical differences between the study group and the control group （ P 〉 0. 05 ） , while the PaCO2 level had statistical difference between these two groups （ P 〈 0. 05 ） . The pH level at 12 h had no statistical difference compared with the control group （ P 〉 0. 05 ） , but PaO2, PaCO2 and PaO2/FiO2 levels had statistical differences between the two groups （ P 〈 0. 05 ） . The pH and PaO2/FiO2 levels at 24 h had no statistical differences compared with the control group （ P 〉 0. 05 ） , but the PaO2 and PaCO2 levels had statistical differences between the study group and the control group （ P 〈 0. 05 ） . The ventilator parame-ters of positive end-expiratory pressure （ PEEP ） and plateau pressure after 72 h had no statistical differences between the study group and the control group （ P 〉 0. 05 ） , but ventilator parameters of the peak inspiratory pressure, mean airway pressure, tidal volume and minute ventilation had statistical differences compared with the control group （ P 〈 0. 05 ） . The dyspnea remission time, oxygen inhalation time, hospitalization time, duration of NCPAP treatment and hospitalization duration in the study group had statistical differences compared with the control group （ P 〈 0. 05 ） . The incidence rates of pneumonia and periventricular leukomalacia in the study group were lower than those in the control group, but the cure rate was higher than that in the control group, the differences between the two groups were sta-tistically significant （ P 〈 0. 05 ） . Conclusion Implementing the nursing intervention during Calsurf combined with NCPAP for treating preterm NRDS is not only conducive to the observation on the symptoms, signs and clinical indexes, but also can increase the cure rate, reduce the occurrence rate of complications and improve the respiratory status of preterm NRDS, and has significant effect.