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目的:探讨早产儿极低出生体重儿早期应用肺表面活性物质固尔苏联合鼻塞式气道正压通气(nasal continuous posi-tive airway pressure,NCPAP)的临床防治作用。方法:将100例胎龄<30周且在出生后0.5 h内入住重症监护室的早产儿,随机分为2组,治疗组和对照组,两组在常规治疗的基础上,入院后即予气管插管滴入固尔苏。治疗组拔管后,继之NCPAP辅助呼吸,而对照组拔管后则根据患儿病情变化采取规范性治疗。分别比较两组患儿固尔苏使用剂量、气管插管率、气管内插管机械通气治疗时间、呼吸窘迫综合征(respiratory distress syndrome,RDS)发生率及其程度、慢性肺部病变(chronic pulmonary disease,CPD)发生率以及病死率等为疗效指标。结果:治疗组固尔苏使用剂量明显低于对照组,气管插管率、气管内插管机械通气治疗时间、RDS发生率及其程度以及慢性肺部病变发生率明显优于对照组,差异有统计学意义(P<0.05或P<0.01)。结论:早期应用肺表面活性物质联合NCPAP对胎龄<30周的早产儿能降低气管插管率,减少固尔苏用量,缩短机械通气时间,减少新生儿RDS发生率及其程度,减少CPD的发生率,有一定的临床意义。
Objective: To investigate the clinical effect of nasal continuous posi-tive airway pressure (NCPAP) on early use of low birth weight infants with preterm infants. Methods: 100 cases of gestational age <30 weeks and within 0.5 h after birth admitted to intensive care unit of premature children were randomly divided into two groups, the treatment group and the control group, two groups on the basis of conventional treatment, after admission Tracheal intubation drip into Cesar. After extubation in the treatment group, followed by NCPAP assisted breathing, while the control group after extubation is based on changes in the condition of children to take normative treatment. Comparing the dosage of celbuterol, tracheal intubation rate, time of endotracheal intubation mechanical ventilation, incidence and degree of respiratory distress syndrome (RDS), chronic pulmonary disease (chronic pulmonary disease disease, CPD) incidence and mortality as the efficacy index. Results: The dosage of cilostazol in the treatment group was significantly lower than that in the control group. The rate of endotracheal intubation, the time of endotracheal intubation mechanical ventilation, the incidence and extent of RDS and the incidence of chronic pulmonary lesions were significantly better than those of the control group Statistical significance (P <0.05 or P <0.01). CONCLUSIONS: Early application of pulmonary surfactant combined with NCPAP can reduce tracheal intubation rate, reduce the amount of cortisol, shorten the duration of mechanical ventilation, reduce the incidence and extent of neonatal RDS, and reduce the incidence of CPD in preterm infants with gestational age <30 weeks The incidence, there is a certain clinical significance.