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目的:观察肺表面活性物质在近足月儿呼吸窘迫综合征救治中的作用。方法:按照家属自愿的原则将41例确诊为新生儿呼吸窘迫综合征且胎龄介于34周-36周之间的近足月儿分为治疗组及对照组,治疗组23例,对照组18例,比较两组患儿血气分析结果、呼吸机参数、气管插管率、上机时间、存活率及住院时间。结果:治疗组患儿,用药后无论临床表现还是胸片均有不同程度的改善。用药后6小时,治疗组PaO2及PaCO2均优于对照组(P<0.05);比较两组中机械通气患儿呼吸机参数,治疗组明显低于对照组(P<0.05);治疗组气管插管率明显低于对照组,且上机时间(nCPAP、nIPPV、气管插管机械通气)也较对照组明显缩短(P<0.05),但两组患儿存活率及住院时间差异无统计学意义。结论:对于近足月呼吸窘迫综合征患儿,尽早明确诊断并在发病早期给予PS替代治疗,可提高此类患儿的生存率及预后,对降低早产儿病死率有重要意义!
Objective: To observe the role of pulmonary surfactant in the treatment of respiratory distress syndrome in nearly full-term children. Methods: According to the principle of voluntary family members, 41 infants with respiratory distress syndrome diagnosed as neonatal respiratory distress syndrome and gestational age between 34 weeks and 36 weeks were divided into treatment group and control group. The treatment group (23 cases) and the control group Eighteen cases were compared between the two groups in the blood gas analysis results, ventilator parameters, tracheal intubation rate, on-machine time, survival rate and hospital stay. Results: The treatment group of children, regardless of clinical manifestations or chest X-ray after treatment have varying degrees of improvement. PaO2 and PaCO2 in the treatment group were better than those in the control group at 6 hours after treatment (P <0.05). Comparing the ventilator parameters in the two groups with mechanical ventilation, the treatment group was significantly lower than the control group (P <0.05) (NCPAP, nIPPV, endotracheal intubation mechanical ventilation) were also significantly shorter than those in the control group (P <0.05), but there was no significant difference in survival rate and hospital stay between the two groups . CONCLUSIONS: For children with near full-term respiratory distress syndrome, early diagnosis and early replacement of PS may improve the survival rate and prognosis of these children. It is of great importance to reduce the mortality of premature children!