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目的探讨猪肺表面活性物质(固尔苏)治疗新生儿呼吸窘迫综合征气管内滴注的体位。方法回顾性分析我院新生儿重症监护病房2002年8月至2008年10月机械通气34例诊断新生儿呼吸窘迫综合征,气管内滴注固尔苏的完整临床资料,随机分为两组:实验组为快速将药物分为三等份于单一仰卧位注入肺内;对照组为将药物分成为三等份于左侧卧位、右侧卧位、仰卧位三个体位注入肺内。观察两组患儿氧饱和度下降、用药72 h后胸部X线片改善情况和脱管、肺出血、颅内出血(头颅B超和头颅CT证实)、呼吸机相关性肺炎、支气管肺发育不良、气胸等并发症及其转归。结果两组患儿氧饱和度下降、用药72 h后胸部X线片明显改善和肺出血、呼吸机相关性肺炎、支气管肺发育不良、气胸等并发症及转归无统计学差异(P>0.05),但两组脱管和颅内出血两种并发症统计学有显著性差异(P<0.05)。结论和三体位相比单一仰卧位分次气管内滴注固尔苏治疗NRDS的效果相同且可减少脱管和颅内出血的风险,是临床值得推广的给药体位。
Objective To investigate the position of endotracheal instillation of porcine pulmonary surfactant (Curetu) in neonatal respiratory distress syndrome. Methods A retrospective analysis of our hospital neonatal intensive care unit from August 2002 to October 2008 mechanical ventilation in 34 cases of neonatal respiratory distress syndrome diagnosis, intratracheal infusion of Guer Su complete clinical data were randomly divided into two groups: In the experimental group, the drug was rapidly divided into three equal parts into the lungs in a single supine position. In the control group, the drug was divided into three equal parts into the left lateral position, the right lateral position and the supine position into the lungs. Oxygen saturation was observed in both groups. Chest radiographs were taken at 72 h after drug administration. The improvement of thoracic radiographs, delamination, pulmonary hemorrhage, intracerebral hemorrhage (confirmed by cranial ultrasound and cranial CT), ventilator-associated pneumonia, bronchopulmonary dysplasia, Pneumothorax and other complications and its outcome. Results The oxygen saturation of children in both groups decreased. There was no significant difference in complication and prognosis between chest X-ray film and pulmonary hemorrhage, ventilator-associated pneumonia, bronchopulmonary dysplasia and pneumothorax at 72 h after treatment ), But there was a significant difference between the two groups in the complications of debridement and intracranial hemorrhage (P <0.05). Conclusions Compared with the three-body position, the single supine sub-intratracheal instillation of cortisol has the same effect on NRDS and can reduce the risk of debridement and intracranial hemorrhage. Therefore, it is clinically worthy of promotion.