肺泡表面活性物质联合经鼻气道持续正压通气治疗新生儿呼吸窘迫综合征的疗效观察

Observation of curative effect of pulmonary surfactant combined nasal continuous positive airway pressure treatment of neonatal respiratory distress syndrome

目的分析采用肺泡表面活性物质联合经鼻气道持续正压通气治疗新生儿呼吸窘迫综合征的疗效。方法通过把我院新生儿科2014年1月-2015年2月收治的诊断为新生儿呼吸窘迫综合症的45例患儿分为观察组与对照组,观察组采用肺泡表面活性物质联合经鼻气道持续正压通气（NCPAP）治疗,对照组采用经鼻气道持续正压通气治疗,观察两组患儿治疗前后临床症状、肺部X线、动脉血氧分压（Pa O2）等变化及预后情况。结果两组患儿在治疗12h后二氧化碳分压（Pa CO2）、氧合指数（OI）明显下降,Pa O2、动脉/肺胞氧分压比值（a/AO2）明显上升。与治疗前相比均有统计学意义（P〈0.05）,治疗后12-24h复查胸部X线片观察组好转率达80.9%,而对照组好转率为50.0%,两组对比差异有统计学意义（P〈0.05）,观察组治愈好转率85.7%明显高于对照组58.3%（P〈0.05）,并发症发生率明显低于对照组（P〈0.05）差异均有统计学意义,平均住院天数观察组亦明显少于对照组,差异有统计学意义（P〈0.05）。结论两种方式治疗新生儿呼吸窘迫综合征均可以有效起到治疗作用,而PS联合NCPAP治疗NRDS能更好地改善氧合,降低NRDS病死率,减少并发症发生。

Objective To anayze the curative effect of pulmonary surfactant combined nasal continuous positive airway pressure in the treatment of neonatal respiratory distress syndrome. Methods 45 children with neonatal respiratory distress syndrome,who were received,cured and diagnosed in neonatal department of our hospital from January 2014 to Februry 2015,were divided into observation group and control group,while observation group was treated with PS combined NCPAP,and control group was treated with NCPAP.To observe the changes of clinical symptoms,chest x-ray,and arterial partial pressure of oxygen（Pa O2）and so on pre and post treatment between the two groups. Results Arterial carbon dioxide（Pa CO2）,oxygenation index（OI） has obviously decreased,while Pa O2,artery/alveole oxygen partial pressure（a/AO2） has obviously increased after treatment 12 h between the two groups,the differences were statically significant compared with pre-treatment（P〈0.05）.The improvement rate of chest x-ray reexamination after treatment 12-24 h in observation group（80.9%） was better than which in control group（50.0%）,the differences was statically significant（P〈0.05）.The cured improvement rate in observation group（85.7%） was obviously higher than which in control group（58.3%）,the complication rate in observation group was obviously lower than which in control group,the average hospitalization days in observation group were obviously less than which in control group,the differences were statically significant（P〈0.05）. Conclusion The two treatment modality in the treatment of neonatal respiratory distress syndrome were effective,while PS combined NCPAP could better improve oxygenation,could decrease the mortality of NRDS,could reduce the occurrence of complication.