摘要
目的 探讨（INSURE策略经口气管插管-肺表面活性物质-拔管使用鼻塞式持续气道正压通气）与机械通气治疗新生儿呼吸窘迫综合征（NRDS）的效果以及对呼吸机相关肺炎（VAP）的影响。方法 选择2014年8月~2015年12月我院收治的120例NRDS患儿,根据其入院顺序分为观察组（INSURE策略）和对照组（使用肺表面活性物质后给予机械通气）,各60例,比较两组患儿治疗后动脉血气以及VAP发生率。结果 两组患儿治疗前血气分析比价,差异无统计学意义（P〉0.05）,两组治疗后1 h的Pa O2分别为（80.52±6.73）mm Hg和（80.41±6.55）mm Hg,治疗后12 h的Pa O2分别为（90.32±5.88）mm Hg和（90.48±6.04）mm Hg,差异无统计学意义（P〉0.05）;两组VAP发生率分别为1.67%和11.67%（P〈0.05）,治愈率分别为88.33%和85.00%,差异无统计学意义（P〉0.05）。结论 INSURE策略与机械通气治疗NRDS疗效相当,但INSURE策略对降低患儿VAP发生率具有积极的效果,适合推广。
Objective To investigate the effects of application of INSURE strategy,the orotracheal intubation-pulmonary surfactant（PS）-post-extubation nasal continuous positive airway pressure（nCPAP ）ventilation and mechanical ventilation in the treatment of neonatal respiratory distress syndrome （NRDS） and their influence on Ventilator Associated Pneumo- nia （VAP）.nethods Altogether 120 cases of NRDS patients who were treated in the hospital from August 2014 to De- cember 2015 were involved as the object of this study and divided into observation group （treated with INSURE strategy） and control group （treated with mechanical ventilation after pulmonary surfactantadministration） according to their hospital admission sequence,with 60 cases in each group.The post-treatment arterial blood gas （ABG） and the incidence of VAP between the two groups were compared.Results Neither group showed no significant difference in pre-ABG （P〉 0.05）;while,PaO2 （arterial partial pressure of oxygen） of observation group and control group at 1 h and 12 h post-treat- ment was （80.52±6.73） mmHg vs （80.41±6.55） mmHg,and （90.32±5.88） mmHg vs （90.48±6.04） mmHg respectively.No significant difference was seen between the ABG analysis results of neither group （P〉0.05）.The incidence of VAP and curative rate of observation group and control group were 1.67% vs 11.67% （P〈0.05）,and 88.33% vs 85.00% without significant difference （P〉0.05）.Conclusion The INSURE strategy and mechanical ventilation prove equal efficacy in treatment of NRDS,among which the INSURE strategy has positive effects on reduction of the incidence of VAP in children and is suitable for popularization and application.
出处
《中国当代医药》
2016年第24期93-95,共3页
China Modern Medicine
