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目的研究经口气管插管-肺表面活性物质(PS)-拔管使用鼻塞式持续气道正压通气(INSURE策略)治疗早产儿呼吸窘迫综合征(NRDS)临床疗效,可靠程度及安全性。方法 60例符合诊断NRDS患儿随机分为治疗组和对照组,每组30例,治疗组给予INSURE策略治疗,对照组给予鼻塞式持续气道正压通气(NCPAP)治疗。两组均给予相同常规治疗。比较两组治疗前和使用PS后3 h、6 h、24 h的血气分析,治疗前和用药后6 h、24 h胸部X线评分、NCPAP使用时间、用氧时间及住院天数。结果治疗组患儿6 h后血气分析、X线转归与对照组比较差异有统计学意义(P<0.05),两组NCPAP使用时间、用氧时间、住院天数比较差异有统计学意义(P<0.01)。结论 INSURE策略通过改善氧合及通气,减轻NRDS程度,是一种安全、有效治疗早产儿呼吸窘迫综合征的方法;动物源性肺表面活性物质是一种安全、有效生物制剂。
Objective To investigate the clinical efficacy, reliability and safety of nasal continuous positive airway pressure ventilation (INSURE strategy) for the treatment of respiratory distress syndrome (NRDS) in preterm infants through orotracheal intubation - pulmonary surfactant (PS) - extubation. Methods Sixty children with diagnosed NRDS were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was given INSURE strategy while the control group was given nasal continuous positive airway pressure (NCPAP) treatment. Both groups were given the same routine treatment. Blood gas analysis was performed before treatment and 3h, 6h, 24h after PS treatment. Chest X-ray score, NCPAP use time, oxygen administration time and hospitalization days before treatment and 6 h and 24 h after treatment were compared between the two groups. Results There was significant difference between the two groups in blood gas analysis and X-ray prognosis in 6 h after treatment in the treatment group (P <0.05). There was significant difference in the time of using NCPAP, <0.01). Conclusion The INSURE strategy is a safe and effective method to treat respiratory distress syndrome in preterm infants by improving oxygenation and ventilation and alleviating the degree of NRDS. Animal derived pulmonary surfactant is a safe and effective biological preparation.