双水平气道正压通气联合肺泡表面活性物质治疗早产儿呼吸窘迫综合征疗效分析
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摘要
目的分析双水平气道正压通气(BiPAP)联合肺泡表面活性物质(PS)治疗早产儿呼吸窘迫综合征(RDS)的临床疗效。方法选取2016年8月～2018年8月收治于潍坊市人民医院新生儿科的早产儿呼吸窘迫综合征患儿60例,按照入院顺序随机将其分为治疗组和对照组各30例。在常规治疗的基础上治疗组应用BiPAP治疗,对照组应用持续气道正压通气(CPAP)治疗,比较两组患儿的动脉血气变化、临床疗效、通气时间、用氧时间和并发症发生情况。结果治疗后,治疗组PaO_2及PaCO_2较对照组明显改善;治疗组总有效率(93.33%)明显高于对照组(73.33%);治疗组通气时间及用氧时间较对照组明显缩短;差异均具有统计学意义(P<0.05);两组并发症发生率无统计学差异(P>0.05)。结论 BiPAP联合PS治疗早产儿RDS疗效确切,值得推广。
Objective To analyze the clinical efficacy of bi-level positive airway pressure(BiPAP) combined with pulmonary surfactant in the treatment of respiratory distress syndrome in preterm infants.Methods Sixty children with premature infants with respiratory distress syndrome admitted to the Department of Neonatology,Weifang People's Hospital from August 2016 to August 2018 were randomly divided into treatment group and control group according to the order of admission.On the basis of conventional treatment,the treatment group was treated with BiPAP,and the control group was treated with continuous positive airway pressure.The changes of arterial blood gas,clinical efficacy,ventilation time,oxygen time and complications were compared between the two groups.Results After treatment,PaO_2 and PaCO_2 in the treatment group were significantly improved compared with the control group;the total effective rate(93.33%) in the treatment group was significantly higher than that in the control group(73.33%);the ventilation time and oxygen time in the treatment group were significantly shorter than those in the control group;Statistical significance(P<0.05);there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion BiPAP combined with PS in the treatment of premature infants with RDS is definite and worthy of promotion.
Objective To analyze the clinical efficacy of bi-level positive airway pressure(BiPAP) combined with pulmonary surfactant in the treatment of respiratory distress syndrome in preterm infants.Methods Sixty children with premature infants with respiratory distress syndrome admitted to the Department of Neonatology,Weifang People's Hospital from August 2016 to August 2018 were randomly divided into treatment group and control group according to the order of admission.On the basis of conventional treatment,the treatment group was treated with BiPAP,and the control group was treated with continuous positive airway pressure.The changes of arterial blood gas,clinical efficacy,ventilation time,oxygen time and complications were compared between the two groups.Results After treatment,PaO_2 and PaCO_2 in the treatment group were significantly improved compared with the control group;the total effective rate(93.33%) in the treatment group was significantly higher than that in the control group(73.33%);the ventilation time and oxygen time in the treatment group were significantly shorter than those in the control group;Statistical significance(P<0.05);there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion BiPAP combined with PS in the treatment of premature infants with RDS is definite and worthy of promotion.
引文
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[11] 张慧杰,温晓红.双水平正压通气在早产儿呼吸支持中的应用进展[J].中国儿童保健杂志,2018,26(8):858～861.
[2] 耿云.肺泡表面活性物质治疗新生儿呼吸窘迫综合征的临床价值研究[J].中国卫生标准管理,2014,5(13):61～62.
[3] Liu JF,Liu G,Wu HW,et al.Efficacy study of pulmonary surfactant combined with assisted ventilation for acute respiratory distress syndrome management of term neonates[J].Exp Ther Med,2017,14(3):2608～2612.
[4] 王乐.肺表面活性物质在新生儿呼吸窘迫综合征中的应用效果及对疾病指标的影响[J].中国妇幼保健,2017,32(12):2650～2652.
[5] Sweet DG,Carnielli V,Greisen G,等.欧洲新生儿呼吸窘迫综合征防治共识指南:2016版[J].中华儿科杂志,2017,55(3):169～176.
[6] 中华医学会儿科学分会新生儿学组.早产儿无创呼吸支持临床应用建议[J].中华儿科杂志,2018,56(9):643～647.
[7] Roberts CT,Davis PG,Owen LS.Neonatal non-invasive respiratory support:synchronised NIPPV,non-synchronised NIPPV or bi-level CPAP:what is the evidence in 2013[J].Neonatology,2013,104(3):203～209.
[8] 王娜,张立明,张爱梅,等.气泡式鼻塞持续气道正压通气联合氨溴索早期防治早产儿呼吸窘迫综合征疗效研究[J].中华妇幼临床医学杂志(电子版),2012,8(2):152～155.
[9] 中华医学会儿科学分会急救学组,中华医学会急诊医学分会儿科学组,中国医师协会儿童重症医师分会.儿童双水平气道正压通气临床应用专家共识[J].中华儿科杂志,2017,55(5):324～328.
[10] 高翔羽,黑明燕.双水平气道正压通气在早产儿呼吸窘迫综合征中的应用[J].中华儿科杂志,2013,51(10):756～758.
[11] 张慧杰,温晓红.双水平正压通气在早产儿呼吸支持中的应用进展[J].中国儿童保健杂志,2018,26(8):858～861.