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目的:探讨气管插管-肺表面活性物质(PS)-拔管联合鼻塞式持续气道正压通气(INSURE)在新生儿呼吸窘迫综合征(NRDS)的临床应用价值。方法:将深圳市宝安区福永医院2013月5月至2015年6月确诊收治的有呼吸困难且需要插管的新生儿120例,依据方法不同分为INSURE(治疗组)60例以及常频通气联合PS(对照组)60例。比较两组患儿治疗24 h动脉血气改善情况以及呼吸机相关性肺炎、气漏、颅内出血发生率,呼吸机使用时间、氧疗时间、颅内出血等。结果:治疗组的动脉血氧分压明显高于对照组,二氧化碳分压明显低于对照组,组间比较,差异具有统计学意义(P<0.01)。治疗组呼吸机相关性肺炎、颅内出血、气漏、呼吸机使用时间、氧疗时间发生率明显低于对照组,组间比较,差异具有统计学意义(P<0.01)。结论:INSURE技术治疗NRDS并发症明显减少、创伤减小。
Objective: To investigate the clinical value of endotracheal intubation - pulmonary surfactant (PS) - extubation combined with nasal continuous positive airway pressure (INSURE) in neonatal respiratory distress syndrome (NRDS). Methods: From January 2013 to June 2015, Fuyong Hospital, Bao’an District, Shenzhen, 120 newborns with dyspnea who needed intubation admitted to the hospital were divided into two groups according to the different methods: INSURE (treatment group) Combined PS (control group) 60 cases. The improvement of arterial blood gas and ventilator-associated pneumonia, air leak, incidence of intracranial hemorrhage, ventilator use time, oxygen therapy time and intracranial hemorrhage were compared between the two groups in 24 h treatment. Results: The arterial partial pressure of oxygen of the treatment group was significantly higher than that of the control group, and the partial pressure of carbon dioxide was significantly lower than that of the control group. There was significant difference between the two groups (P <0.01). The incidence of ventilator-associated pneumonia, intracranial hemorrhage, air leak, ventilator use time and oxygen therapy time in the treatment group were significantly lower than those in the control group. The differences between the two groups were statistically significant (P <0.01). CONCLUSIONS: The complications of NRDS in treatment of NRDS are significantly reduced and trauma is reduced.