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目的探讨牛肺泡表面活性剂联合鼻塞持续气道正压(NCPAP)治疗新生儿呼吸窘迫综合征的临床效果。方法选取我科2012年1月至11月我院新生儿科收治的早产儿呼吸窘迫综合征病例80例,分为治疗组40例,对照组40例,2组在一般治疗的基础上,对照组给予NCPAP治疗,治疗组用牛肺泡表面活性剂联合NCPAP治疗,牛肺泡表面活性剂使用剂量70~100 mg·kg-1,经气道内滴入,动态观察使用牛肺泡表面活性剂后0,2,12,24 h患儿的血气分析结果和NCPAP参数调整情况,包括血气分析、吸入氧浓度、呼吸末正压情况,并统计NCPAP通气时间、氧疗时间、住院时间及死亡率。结果治疗组在治疗后2,12和24 h血PaO2、血PH值明显升高,血PaCO2、吸氧浓度和PEEP明显降低,与对照组比较,差异有统计学意义(P<0.001)。治疗组NCPAP使用时间﹑氧暴露时间﹑住院天数和死亡率低于对照组,2组比较差异有统计学意义(P<0.001)。结论牛肺泡表面活性剂联合NCPAP治疗新生儿呼吸窘迫综合征效果显著,且价格优惠,值得临床上推广应用。
Objective To investigate the clinical effects of bovine alveolar surfactant combined with nasal continuous positive airway pressure (NCPAP) in the treatment of neonatal respiratory distress syndrome. Methods 80 cases of respiratory distress syndrome in premature infants admitted to our hospital from January 2012 to November 2012 were divided into treatment group (40 cases) and control group (40 cases). The two groups were treated on the basis of general treatment. The control group Given NCPAP treatment, the treatment group with bovine alveolar surfactant combined with NCPAP treatment, bovine alveolar surfactant dose of 70 ~ 100 mg · kg-1, by airway instillation, the dynamic observation of bovine alveolar surfactant after 0,2 , 12,24 h in children with blood gas analysis results and adjustment of NCPAP parameters, including blood gas analysis, inhaled oxygen concentration, positive end-expiratory pressure, and statistics NCPAP ventilation time, oxygen therapy time, hospital stay and mortality. Results After 2, 12 and 24 h of treatment, the PaO2 and PaO2, PaCO2 and PEEP of the treated group were significantly increased. Compared with the control group, the difference was statistically significant (P <0.001). NCPAP use time, oxygen exposure time, hospitalization days and mortality in the treatment group were lower than those in the control group. There was significant difference between the two groups (P <0.001). Conclusion Bovine alveolar surfactant combined with NCPAP treatment of neonatal respiratory distress syndrome effect is significant, and the price is favorable, it is worth promoting the clinical application.