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【目的】评价Silverman Anderson(SA)评分在早期处理呼吸窘迫综合征(respiratory distress syndrome,RDS)早产儿时的应用价值。【方法】按照呼吸支持开始前SA评分分值将130例RDS患儿分为轻度(3～5分)、中度(6～7分)和重度(8～10分)三组,将三组患儿的呼吸支持治疗前、治疗初的有关指标进行比较。【结果】1)轻、中和重度RDS三组之间心率(F=17.792)、呼吸次数(F=8.990)、平均动脉压(F=8.677)、吸入氧浓度(F=69.187)和氧合指数(F=50.807)比较差异均有高度统计学意义(P<0.01),各组之间数值两两比较差异也均有统计学意义(P<0.05),心率、呼吸次数和吸入氧浓度变化呈增加趋势,平均动脉压和氧合指数变化呈降低趋势;2)轻度组和中度组之间NCPAP压力比较差异有统计学意义(F=83.216,P=0.000),中度组的压力显著增高;3)轻、中、重度RDS三组间胸部X线片RDS分级(χ2=33.24)、NCPAP治疗成功例数及需要气管插管机械通气例数(χ2=62.62)比较差异均有统计学意义(P值均=0.000);4)NCPAP治疗成功与失败的SA分值比较差异有统计学意义(F=13.404,P=0.001)。【结论】SA评分可以比较客观地反映RDS患儿的呼吸窘迫程度和病情的严重程度,有利于临床医师在床边客观快速评估患儿病情,及时作出正确的处理措施,提高RDS的救治质量。
【Objective】 To evaluate the value of Silverman Anderson (SA) score in the early treatment of premature infants with respiratory distress syndrome (RDS). 【Methods】 130 patients with RDS were divided into mild (3-5), moderate (6-7) and severe (8-10) groups according to the score of SA before respiration support. Three groups of three Respiratory support group before treatment, early treatment of the relevant indicators were compared. 【Results】 1) Heart rate (F = 17.792), respiratory rate (F = 8.990), mean arterial pressure (F = 8.677), inhaled oxygen concentration (F = 69.187) and oxygenation (F = 50.807) (P <0.01). There was also significant difference between the two groups (P <0.05), heart rate, respiratory rate and inhaled oxygen concentration The average arterial pressure and oxygenation index decreased; 2) There was significant difference in NCPAP pressure between mild and moderate groups (F = 83.216, P = 0.000), moderate pressure (Χ2 = 33.24), the successful cases of NCPAP treatment and the number of cases requiring mechanical ventilation of tracheal intubation (χ2 = 62.62) were statistically significant (P = 0.000); 4) There was significant difference in SA score between NCPAP success and failure (F = 13.404, P = 0.001). 【Conclusion】 The SA score can objectively reflect the degree of respiratory distress and the severity of the disease in RDS children. It is good for clinicians to objectively and quickly evaluate the condition of children in bedside and to make the correct treatment measures in time to improve the quality of RDS treatment.