肺表面活性物质与鼻塞持续气道正压通气治疗新生儿呼吸窘迫综合征

作者：陈素玲，赵若雯，江霞辉

【摘要】目的探讨肺表面活性物质（PS）与鼻塞持续气道正压通气（NCPAP）治疗新生儿呼吸窘迫综合征（NRDS）的疗效。方法对32例住院确诊新生儿呼吸窘迫综合征患儿，在常规治疗基础上分为PS联合NCPAP组16例，NCPAP组16例，观察治疗前后两组患儿的血气，X线胸片及并发症情况。结果治疗后0.5h，两组患儿PaO2和PaO2/FiO2升高，PCO2下降,至6、12、24、72h,PaO2和PaO2/FiO2仍明显高于治疗前水平，PCO2明显低于治疗前水平，差异有非常显著性（P<0.01）。两组PaO2、PaO2/FiO2和PCO2差异无显著性（P>0.05）。PS联合NCPAP组用氧时间、住院时间明显短于NCPAP组，差异有显著性（P<0.05）。且NCPAP4例治疗无效，改常规机械通气（CMV），PS联合NCPAP组仅1例无效改用CMV。结论PS联合NCPAP治疗NRDS能快速有效地改善肺换气和通气的功能，缩短用氧时间和住院时间，减少常规机械通气的应用，减少并发症的发生率，提高治愈率。

【关键词】肺表面活性物质；鼻塞持续气道正压通气；新生儿；呼吸窘迫综合征

［Abstract］ObjectiveToinvestigatethepulmonarysurfactant（PS）withnasalcontinuouspositiveairwaypressure（NCPAP）treatmentforneonatalrespiratorydistresssyndrome（NRDS）.Methods32casesofNRDSintheconventionaltreatmentbasedonthePSweredividedinto16casesofjointNCPAPgroupand16casesofNCPAPgroup.Theblood,X-rayandcomplicateddiseasesituationwereobservedbeforeandaftertreatment.ResultsAftertreatment,PaO2andPaO2/FiO2increased,PCO2decreasedto6,12,24,72h,PaO2andPaO2/FiO2wasstillsignificantlyhigherthanthelevelbeforetreatment,PCO2wassignificantlylowerthanthelevelbeforetreatmentsignificantly（P<0.01）.TherewasnosignificantdifferencebetweentwogroupsinPaO2,PaO2/FiO2andPCO2（P>0.05）.PSJointwithoxygenNCPAPgrouptime,lengthofstaywassignificantlyshorterintheNCPAPgroup,therewasasignificantdifference（P<0.05）.ConclusionPSandNCPAPtreatmentcanquicklyandeffectivelyimprovepulmonaryventilationandventilationfunctions,reducetheuseofoxygenandhospitalizationtime,reducetheapplicationofconventionalmechanicalventilationandtheincidenceofcomplicationsandimprovecurerate.

［Keywords］pulmonarysurfactant;nasalcontinuouspositiveairwaypressure;newborns;respiratorydistresssyndrome.