机械通气联合PS对早产儿RDS的治疗效果被引量：6

Clinical Analysis of Respiratory Distress Syndrome(RDS)in Premature Infants under Mechanical Ventilation Combined with Pulmonary Surfactant(PS)Treatment

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摘要目的:探讨机械通气下肺表面活性物质(PS)开始使用时间对早产儿呼吸窘迫综合征(RDS)的治疗效果。方法:100例机械通气联合PS治疗的RDS的早产儿分为A组(PS开始治疗时间为新生儿出生后小时龄<6 h)、B组(PS开始治疗时间为新生儿出生后小时龄≥6 h~<12 h)和C组(PS开始治疗时间为新生儿出生后小时龄≥12 h),收集并比较3组早产儿的临床资料及转归情况;于PS治疗前、治疗后3~6 h、12 h及24 h时取各组患儿左手桡动脉血,检测血气指标pH值、动脉氧分压(PaO2)及动脉二氧化碳分压(PaCO2),并计算氧合指数(PaO2/FiO2)。结果:PS治疗后,3组患儿的pH值、PaO2及PaO2/FiO2较用药前上升,PaCO2较用药前下降,且以A组改变最明显(P<0.05);A组早产儿的插管呼吸机使用率、肺部感染率、BPD发生率及病死率均低于C组(P<0.05)。结论:呼吸机辅助通气联合PS治疗对RDS患儿有效,尽早使用PS效果更好。 Objective:To investigate the effect of starting time of using pulmonary surfactant(PS)under mechanical ventilation on premature infants with respiratory distress syndrome(RDS).Methods:Based on starting time of using PS,one hundred premature infants with RDS treated by mechanical ventilation combined with PS were divided into group A(<6 hours after birth),group B(6~12 hours after birth)and group C(≥12 hours after birth).The clinical data and outcomes of preterm infants were collected and compared.Before PS treatment,at 3~6 h,12 h and 24 h after PS treatment,the left hand radial arterial blood was collected,and the blood gas indexes including pH values,arterial oxygen partial pressure(PaO2)and arterial carbon dioxide partial pressure(PaCO2)were measured and oxygenation index(PaO2/FiO2)was calculated.Results:After PS treatment,the pH value,PaO2 and PaO2/FiO2 of newborns in the three groups increased and PaCO2 decreased than before,and the changes were most obvious in group A(P<0.05).The rates of intubation ventilator and pulmonary infection,BPD incidence and mortality of premature infants were lower in group A than those in group C(P<0.05).Conclusion:Ventilator-assisted ventilation combined with PS therapy is effective for newborns with RDS,and early use of PS had improved clinical outcomes.

作者方婉茹王鉴 FANG Wanru;WANG Jian(Department of Neonatology,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区贵州医科大学附院新生儿科

出处《贵州医科大学学报》 CAS 2020年第4期491-496,共6页 Journal of Guizhou Medical University

基金贵州省科技厅科学技术基金[黔科合LG字(2012)052号]。

关键词呼吸窘迫综合征新生儿通气机机械早产儿肺表面活性物质血气指标并发症 respiratory distress syndrome(RDS) newborn ventilators mechanical premature infant pulmonary surfactant(PS) arterial blood gas index complications