肺表面活性物质救治近足月儿呼吸窘迫综合征的临床疗效观察

目的:观察肺表面活性物质在近足月儿呼吸窘迫综合征救治中的作用。方法:按照家属自愿的原则将41例确诊为新生儿呼吸窘迫综合征且胎龄介于34周-36周之间的近足月儿分为治疗组及对照组,治疗组23例,对照组18例,比较两组患儿血气分析结果、呼吸机参数、气管插管率、上机时间、存活率及住院时间。结果:治疗组患儿,用药后无论临床表现还是胸片均有不同程度的改善。用药后6小时,治疗组PaO2及PaCO2均优于对照组(P<0.05);比较两组中机械通气患儿呼吸机参数,治疗组明显低于对照组(P<0.05);治疗组气管插管率明显低于对照组,且上机时间(nCPAP、nIPPV、气管插管机械通气)也较对照组明显缩短(P<0.05),但两组患儿存活率及住院时间差异无统计学意义。结论:对于近足月呼吸窘迫综合征患儿,尽早明确诊断并在发病早期给予PS替代治疗,可提高此类患儿的生存率及预后,对降低早产儿病死率有重要意义!

Clinical Observation of Surfactant Treatment on Near-term Neonates RDS Treatment

Objective: To observe function of surfactant in treatment of near-term neonates respiratory distress syndrome. Methods: Divide 41 near-term neonates who was diagnosed as NRDS and gestational age were between 34 weeks and 36 weeks into therapy group and control group, 23 cases were in therapy group, 18 cases were in control group. Comparing their blood gas, ventilator parameters, tracheal intubation rate, mechanical ventilation time, survival rate and hospitalization time. Results: In therapy group, both clinical symptoms and chest radiograph got better after giving surfactant. Six hours after giving surfactant, PaO2 and PaCO2 were better than control group(P<0.05); Comparing their ventilator parameters, therapy group obviously lower than control group(P<0.05); Besides, tracheal intubation rate in therapy group was obviously lower than control group and mechanical ventilation time was significantly shortened(P<0.05). But survival rate and hospitalization time of two groups was not statistically significant. Conclusion: To near-term neonates who was diagnosed as RDS, clarifying diagnosis and giving surfactant as soon as possible can improve survival rates and prognosis of such babies. It has important significance in reducing premature mortality.