| 摘要: |
| 目的:评价气管插管鄄肺表面活性物质鄄拔管(intubation-surfactant-extubation,InSurE)治疗策略在新生儿呼吸窘迫综合征(NRDS)中的临床应用优势。方法:按照入院顺序将80例NRDS早产儿随机分成观察组和对照组各40例,观察组采用InSurE策略治疗,对照组采用早期气管插管肺泡表面活性物质干预后常频通气(CMV)治疗,比较两组患儿治疗前后血气变化、上机时间、住院时间、并发症及转归情况。结果:治疗前两组患儿血气分析及氧合指数比较差异无统计学意义(P>0.05)。治疗后两组患儿的血气指标及氧合指数均明显改善,但观察组较对照组改善更为明显,差异有统计学意义(P<0.05)。观察组住院时间短于对照组,差异有统计学意义(P<0.05)。观察组患儿呼吸机相关性肺炎发生率均明显低于对照组,差异均有统计学意义(P<0.05)。两组患儿上机时间、颅内出血、坏死性小肠结肠炎、支气管肺发育不良及早产儿视网膜病的发生率比较差异无统计学意义(P>0.05)。结论:InSurE策略能明显改善NRDS患儿的临床严重程度,迅速改善患儿的呼吸功能,显著减少呼吸机相关性肺炎的发生,缩短住院时间,值得推广应用。 |
| 关键词: 新生儿呼吸窘迫综合征 InSurE策略 经鼻持续正压通气 早产儿 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.10.006 |
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| 基金项目: |
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| Intubation-Surfactant-Extubation Strategy in the Treatment of Neonatal Respiratory Distress Syndrome |
| Wang Meiqing, Lin Wei, Guan Xifu, Xu Guichun, Nie Fengyan, Bao Quan |
| (People's Hospital of Lanxi City, Zhejiang Province, Zhejiang Lanxi 321100, China) |
| Abstract: |
| Objective: To evaluate the advantages of clinical application of intubation-surfactant-extubation (InSurE) strategy in the treatment of neonatal respiratory distress syndrome (NRDS). Methods: Eighty cases of premature infants were randomly divided into observation group (40 cases) and control group (40 cases) according to the order of admission. The observation group was treated with InSurE strategy. After early tracheal intubation and pulmonary surfacant intervention, conventional mechanical uentilation (CMV) treatment was given in the control group. Changes of blood gas, time on the device, length of hospital stay, complications and prognosis were compared between the two groups before and after treatment. Results: Before treatment, there were no significant differences in blood gas analysis and oxygenation indexes between the two groups (P>0.05). After treatment, the blood gas indexes and oxygenation indexes of the two groups were significantly improved, but the improvement in the observation group was more significant than that in the control group (P<0.05). The length of hospital stay in the observation group was significantly shorter than that of the control group (P<0.05). The incidence of ventilator associated pneumonia in the observation group was significantly lower than that in the control group (P<0.05). There were no significant differences in the time on device, incidence rates of intracranial hemorrhage, necrotizing enterocolitis, bronchopulmonary dysplasia and neonatal retinopathy between the two groups (P>0.05). Conclusion: InSurE strategy can significantly improve the clinical severity of NRDS, improve the respiratory function rapidly, reduce the incidence of ventilator associated pneumonia significantly and shorten the length of hospital stay. It is worth popularizing. |
| Key words: neonatal respiratory distress syndrome InSurE strategy nasal continuous positive airway pressure premature infant |
