摘要
目的探讨机械通气(MV)联合肺表面活性物质(PS)治疗早产儿呼吸窘迫综合征(NRDS)的临床疗效。方法回顾性分析2008年7月至2012年6月东莞市横沥医院78例NRDS早产儿临床资料,46例使用肺表面活性物质联合机械通气为研究组,32例单用机械通气为对照组,观察2组患儿的治疗效果、主要血气指标、氧合指数、呼吸机参数、机械通气时间、总吸氧时间和住院时间以及并发症、转归等。结果研究组使用PS 6h后呼吸窘迫症状明显改善;研究组氧合指数(OI)、动脉血二氧化碳分压(PaCO2),呼吸机参数吸入氧浓度(FiO2)、最大吸气峰压(PIP)、平均气道压(MAP)、呼气终末气道正压(PEEP)在治疗后6、12、24h均明显小于对照组,而动脉血氧分压(PaO2)、pH值均明显高于对照组(P<0.05或P<0.01);研究组机械通气时间、总吸氧时间和住院时间均明显小于对照组(P<0.01);研究组呼吸机相关性肺炎(VAP)、呼吸机相关性肺损伤(ventilator associated lung injury,VALI)发生率低于对照组(P<0.05),2组间气胸、肺出血和颅内出血的发生率比较差异无统计学意义(P>0.05)。结论 PS联合MV能迅速有效地治疗早产儿呼吸窘迫综合征,临床症状、机械通气等均有明显改善。
Objective To evaluate the efficacy of mechanical ventilation（MV） combined with pulmonary surfactant（PS） in preterm infants with respiratory distress syndrome（RDS）.MethodsClinical data of preterm infants treated for RDS in Hengli hospital of Dongguan between 2008 and 2012 were analyzed retrospectively.A total of 78 preterm infants were given MV alone（control group,n=32） or in combination with PS（study group,n=46）.Therapeutic efficacy,blood gas parameters,oxygenation index,ventilator parameters,duration of MV,duration of oxygen inhalation,length of hosipital stay,complications,and outcomes were observed in both groups.Results In study group,symptoms of respiratory distress were significantly improved 6 hours after treatment with PS.Compared with control group,oxygenation index,carbon dioxide tension（PaCO2）,inspired oxygen concentration（FiO2）,peak inspiratory pressure（PIP）,mean airway pressure（MAP） and positive end-expiratory pressure（PEEP） obviously decreased but arterial partial pressure of oxygen（PaO2） and PH value markedly increased in study group 6,12 and 24 hours after treatment（P〈0.05 or P〈0.01）.The duration of MV,duration of oxygen inhalation and length of hosipital stay in study group were significantly shorter than those in control group（P〈0.01）.In addition,the incidences of ventilator-associated pneumonia and ventilator-associated lung injury in study group were significantly lower than those in control group（P〈0.05）.There were no statistical differences in the incidences of pneumothorax,pneumorrhagia and intracranial hemorrhage between the two groups（P〈0.05）.Conclusion The combined treatment with PS and MV can effectively improve clinical symptoms in preterm infants with RDS.
出处
《南昌大学学报（医学版）》
CAS
2013年第5期36-39,共4页
Journal of Nanchang University：Medical Sciences
关键词
肺表面活性物质
机械通气
呼吸窘迫综合征
早产儿
pulmonary surfactant
mechanical ventilation
respiratory distress syndrome
preterm birth
