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目的观察早期应用气管插管-肺表面活性物质注入-快速拔管后给予经鼻持续气道正压通气(intubation surfactant extubation,INSURE)技术治疗新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)的疗效。方法 NRDS患儿52例依据治疗方法不同分为2组,观察组28例均早期应用INSURE技术,对照组24例给予经鼻持续气道正压通气(nasal continuous positive airway pressure,nCPAP)治疗。比较2组治疗前及治疗后6、24h时pa(O2)、pa(CO2)、pa(O2)/吸氧浓度(fraction of inspiration O2,FiO2),及nCPAP使用时间与治疗成功率。结果 2组治疗6、24h后pa(O2)、pa(O2)/FiO2均较治疗前增高(P<0.05),观察组pa(CO2)较治疗前降低(P<0.05),对照组pa(CO2)与治疗前比较差异无统计学意义(P>0.05);2组治疗后24hpa(O2)、pa(O2)/FiO2及pa(CO2)比较差异有统计学意义(P<0.05);观察组nCPAP使用时间较对照组短、治疗成功率较对照组高(P<0.05)。结论早期应用INSURE技术治疗NRDS可改善患儿通气状况及氧合,缩短nCPAP使用时间,提高治疗成功率。。
OBJECTIVE: To observe the effect of nasal continuous airway pressure extubation (INSURE) on neonatal respiratory distress syndrome (NRDS) after tracheal intubation-pulmonary surfactant injection-rapid extubation. Efficacy. Methods Fifty-two children with NRDS were divided into two groups according to the different treatment methods. The 28 cases in the observation group were all treated with INSURE technique. The control group received nasal continuous positive airway pressure (nCPAP). The pa (O2), pa (CO2), pa (O2) / fraction of inspiration O2 (FiO2), nCPAP use time and treatment success rate were compared between the two groups before and 6 and 24 hours after treatment. Results Compared with those before treatment, pa (O2), pa (O2) / FiO2 in both groups increased significantly (P <0.05) and pa (CO2) (P <0.05). There were significant differences in 24hpa (O2), pa (O2) / FiO2 and pa (CO2) between the two groups after treatment Group nCPAP use of time shorter than the control group, the success rate of treatment was higher than the control group (P <0.05). Conclusion The early application of INSURE in the treatment of NRDS can improve ventilation and oxygenation in children, shorten the use of nCPAP and improve the success rate of treatment. .