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目的通过与传统气管插管机械通气(mechanical ventilation,MV)比较,分析气管插管-肺表面活性物质-拔管使用持续气道正压通气(INtubate-SURfactant-Extubate to CPAP,INSURE)技术防治新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)的作用。方法回顾性分析2011年1月-2012年12月采用INSURE技术(INSURE组)或机械通气(MV组)治疗的127例NRDS患儿,比较两组患儿早期结局(二次使用PS、肺出血、气漏综合症、PPHN、PDA)、晚期结局(BPD、ROP、IVH、PVL);与感染相关并发症(败血症、NEC);预后。结果 1)两组患儿一般情况具有可比性(P>0.05);2)早期结局:INSURE组二次使用PS、肺出血、气漏综合症、PPHN均低于MV组(P<0.05);3)感染相关并发症:败血症发生率更低(P值均<0.05);4)晚期结局:INSURE组BPD、ROP、IVH(III级以上)及PVL与MV组比较差异无统计学意义(P>0.05);5)预后:两组死亡率及治愈率差异无统计学意义(P>0.05)。结论 INSURE技术能更好改善NRDS患儿早期结局,减少二次PS使用,降低肺出血、气漏综合症、PPHN发生;降低败血症的发生;缩短用氧时间;未增加BPD、ROP、IVH、PVL的发生率及死亡率。
OBJECTIVE: To analyze the effects of endotracheal intubation-pulmonary surfactant-extubation (INSAP) on nasal regeneration by comparing with traditional mechanical ventilation (MV) Neonatal respiratory distress syndrome (NRDS). Methods A retrospective analysis of 127 children with NRDS treated with the INSURE technique (INSURE group) or mechanical ventilation (MV group) from January 2011 to December 2012 was conducted to compare the early outcomes of the two groups (PS, pulmonary hemorrhage , Pneumoconiosis syndrome, PPHN, PDA), late outcome (BPD, ROP, IVH, PVL); infection-related complications (sepsis, NEC); Results 2) The early outcome: PSURE, pulmonary hemorrhage, air leak syndrome and PPHN in INSURE group were lower than those in MV group (P <0.05); (P <0.05); 4) Late outcome: there was no significant difference in BPD, ROP, IVH (grade III or above) and PVL between MV group and INSURE group > 0.05) .5) Prognosis: There was no significant difference in mortality and cure rate between the two groups (P> 0.05). CONCLUSIONS: INSURE can improve the early outcome of NRDS children and reduce the use of secondary PS, reduce the occurrence of pulmonary hemorrhage, air leak syndrome and PPHN, reduce the incidence of sepsis, shorten the time of oxygenation, increase the levels of BPD, ROP, IVH and PVL The incidence and mortality.