CPAP联合不同时间应用肺表面活性物质对早产呼吸窘迫综合征患儿预后的影响

Effect of CPAP Combined with Different Time Application of Pulmonary Surfactant on Prognosis of Premature Infants with Respiratory Distress Syndrome

目的观察持续气道正压通气(CPAP)联合不同时间应用肺表面活性物质(PS)对≤32周早产呼吸窘迫综合征(NRDS)患儿预后的影响。方法选取2020年1月-2021年6月上饶市人民医院收治的≤32周早产NRDS患儿100例,采用随机数字表法分为A组、B组、C组、对照组,各25例。对照组实施经鼻持续气道正压通气(nCPAP)治疗,A组在nCPAP治疗基础上2 h后应用PS,B组在nCPAP治疗基础上2~4 h后应用PS,C组在nCPAP治疗基础上4 h后应用PS;比较各组血气指标、临床疗效、治疗指标及不良反应发生情况。结果各组血气指标均高于治疗前,且对照组、A组、B组、C组血气指标转好幅度依次升高,差异有统计学意义(P<0.05);对照组、A组、B组、C组的治疗总有效率依次升高,差异有统计学意义(P<0.05);对照组、A组、B组、C组的nCPAP治疗时间、肺部啰音消失时间、住院时间依次减少,差异有统计学意义(P<0.05);对照组、A组、B组、C组的不良反应发生率依次降低,差异有统计学意义(P<0.05)。结论nCPAP联合PS治疗早产儿NRDS能够改善患儿预后,且实施nCPAP治疗的时间越长,效果越好。

Objective To observe the effect of CPAP combined with different time application of pulmonary surfactant(PS)on the prognosis of premature infants with respiratory distress syndrome(NRDS)≤32 weeks.Methods A total of 100 premature infants with NRDS≤32 weeks admitted to Shangrao People's Hospital from January 2020 to June 2021 were selected and divided into group A,group B,group C and control group according to random number table method,with 25 cases in each group.The control group was treated with nCPAP,group A was treated with PS at 2 h after nCPAP treatment,group B was treated with PS at 2-4 h after nCPAP treatment,and group C was treated with PS at 4 h after nCPAP treatment.The blood gas indexes,clinical efficacy,treatment indexes and adverse reactions of each group were compared.Results The blood gas indexes of each group were higher than those before treatment,and the blood gas indexes of the control group,group A,group B and group C increased in turn,the difference was statistically significant(P<0.05).The total effective rate of treatment in the control group,group A,group B and group C increased in turn,and the difference was statistically significant(P<0.05).The nCPAP treatment time,lung rale disappearance time and hospitalization time of the control group,group A,group B and group C decreased in turn,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in control group,group A,group B and group C decreased in turn,the difference was statistically significant(P<0.05).Conclusion nCPAP combined with PS can improve the prognosis of premature infants with NRDS,and the longer the nCPAP treatment,the better the effect.