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目的:探讨机械通气治疗新生儿肺透明膜病的疗效。方法:选择在南方医科大学第三附属医院重症监护室病房住院的NHMD患儿42例,采用机械通气结合辅助治疗。结果:42例NHMD患儿治愈率为78.57%(33/42),死亡3例,因经济困难等原因在住院后48~60 h内自动出院6例。在应用呼吸机治疗过程中,患儿并发肺炎18例,均在上机后第3~6天发现,其中气管内分泌物培养出绿脓杆菌9例,金黄色葡萄球菌3例,克雷伯菌3例,鲍曼不动杆菌3例;并发气胸6例,在上机后第3天发现;并发肺出血4例,颅内出血4例,支气管发育不良2例,肺不张2例。结论:及早应用以机械通气为主的综合治疗是提高NHMD抢救成功率的重要措施,但如何减少治疗过程中患儿呼吸机相关性肺炎并发症的发生率仍需要进一步研究。
Objective: To investigate the effect of mechanical ventilation on neonatal hyaline membrane disease. Methods: Forty - two NHMD children admitted to ICU ward of the Third Affiliated Hospital of Southern Medical University were selected with mechanical ventilation and adjuvant therapy. Results: The cure rate of 42 cases of NHMD was 78.57% (33/42) and 3 died. Six patients were discharged automatically within 48-60 hours after hospitalization due to financial difficulties. In the application of ventilator therapy in children with pneumonia in 18 cases were found in the first 3 to 6 days after the discovery of tracheal secretions which cultured in 9 cases of Pseudomonas aeruginosa, Staphylococcus aureus in 3 cases, Klebsiella 3 cases, Acinetobacter baumannii in 3 cases; pneumothorax in 6 cases, found on the first 3 days after the machine; concurrent pulmonary hemorrhage in 4 cases, 4 cases of intracranial hemorrhage, bronchiectasis in 2 cases, 2 cases of atelectasis. Conclusion: The early application of comprehensive therapy based on mechanical ventilation is an important measure to improve the success rate of NHMD rescue. However, how to reduce the incidence of ventilator - associated pneumonia in children during treatment needs further study.