新生儿呼吸窘迫综合征的临床诊疗分析

Analysis on clinical diagnosis and treatment of neonatal respiratory distress syndrome

目的探讨新生儿呼吸窘迫综合征(NRDS)的临床治疗特点。方法回顾性分析2012年1月—2013年1月河北省某三甲医院新生儿监护室(NICU)收治的32例NRDS患儿的临床资料、实验室检查及治疗情况。结果肺部X线检查:Ⅰ级10例(31.3%),Ⅱ级5例(15.6%),Ⅲ级9例(28.1%),Ⅳ级8例(25.0%)。实验室检查:治疗前血常规检查外周血呈炎性反应;血气分析示酸中毒、Pa CO2升高、PO2降低,Sp O2降低;全血超敏C反应蛋白(hs-CRP)为(3.6±12.7)mg/dl,其中<1mg/dl 26例(81.3%),≥1mg/dl 6例(18.8%);血糖(5.22±1.48)mmol/L。治疗后白细胞计数和中性粒细胞分数明显降低;血浆p H值升高,酸中毒明显改善;Pa CO2下降,PO2上升,Sp O2增加。痰培养病原菌检查阳性4例(12.5%);血培养病原菌检查阳性3例(9.4%)。痊愈出院27例(84.4%),好转4例(12.5%),总有效率为96.9%。结论临床应充分重视NRDS患儿的临床表现及实验室检查等情况,早发现、早治疗,以提高临床疗效,减少并发症。

Objective To analyze the clinical diagnosis and treatment of neonatal respiratory distress syndrome. Methods The clinical data of 32 children with NRDS,laboratory examination and treatment admitted to the People＆#39;s Hospital of Linxi County of the neonatal intensive care unit（ NICU）from January 2012 to January 2013 were retrospectively analyzed. Results Pulmonary X - ray check - up：Ⅰlevel 10 cases（ 31. 3%）,Ⅱ level 5 cases（ 15. 6%）,Ⅲ level 9 cases （28. 1%）,Ⅳ level 8 cases（25. 0%）;laboratory examination：before treatment,blood routine examination was peripheral inflammation;blood gas analysis showed acidosis,raised PaCO2 ,reducing PO2 ,SpO2 reduced;whole blood hypersensitive C-reactive protein（hs -CRP）was（3. 6 ± 12. 7）mg/dl,＆lt;1mg/dl 26 cases（81. 3%）,≥1mg/dl 6 cases（18. 8%）;blood glucose was（5. 22 ± 1. 48） mmol/L. After treatment,leukocyte count and neutrophil percentage were decreased;higher plasma pH,improved acidosis;PaCO2 decreased,PO2 raised,SpO2 increased. Sputum culture showed positive pathogen in 4 cases（12. 5%）;blood culture pathogens check were positive in 3 cases（9. 4%）. 27cases were cured（84. 4%）,4 cases were improved（12. 5%）,the total effective rate was 96. 9%. Conclusion NRDS should care the clinical manifestation and laboratory examination,early detection and early treatment,in order to improve the clinical curative effect,reduce the compli-cations.