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目的探讨新生儿呼吸窘迫综合征(NRDS)的临床治疗特点。方法回顾性分析2012年1月—2013年1月河北省某三甲医院新生儿监护室(NICU)收治的32例NRDS患儿的临床资料、实验室检查及治疗情况。结果肺部X线检查:Ⅰ级10例(31.3%),Ⅱ级5例(15.6%),Ⅲ级9例(28.1%),Ⅳ级8例(25.0%)。实验室检查:治疗前血常规检查外周血呈炎性反应;血气分析示酸中毒、Pa CO2升高、PO2降低,Sp O2降低;全血超敏C反应蛋白(hs-CRP)为(3.6±12.7)mg/dl,其中<1mg/dl 26例(81.3%),≥1mg/dl 6例(18.8%);血糖(5.22±1.48)mmol/L。治疗后白细胞计数和中性粒细胞分数明显降低;血浆p H值升高,酸中毒明显改善;Pa CO2下降,PO2上升,Sp O2增加。痰培养病原菌检查阳性4例(12.5%);血培养病原菌检查阳性3例(9.4%)。痊愈出院27例(84.4%),好转4例(12.5%),总有效率为96.9%。结论临床应充分重视NRDS患儿的临床表现及实验室检查等情况,早发现、早治疗,以提高临床疗效,减少并发症。
Objective To investigate the clinical features of neonatal respiratory distress syndrome (NRDS). Methods The clinical data, laboratory tests and treatment of 32 NRDS children admitted to NICU from January 2012 to January 2013 in Hebei Province were retrospectively analyzed. Results Pulmonary X-ray examination showed that grade Ⅰ was found in 10 cases (31.3%), grade Ⅱ in 5 cases (15.6%), grade Ⅲ in 9 cases (28.1%) and grade Ⅳ in 8 cases (25.0%). Laboratory tests: blood routine examination before treatment was inflammatory reaction; blood gas analysis showed acidosis, Pa CO2 increased, PO2 decreased, Sp O2 decreased; whole blood hs-CRP was (3.6 ± 12.7) mg / dl, of which 26 cases (81.3%) were less than 1 mg / dl, 6 cases (18.8%) were more than 1 mg / dl and the blood glucose was 5.22 ± 1.48 mmol / L. After treatment, the white blood cell count and neutrophil fraction decreased significantly; plasma p H increased, acidosis significantly improved; PaCO 2 decreased, P 2 O increased, Sp O 2 increased. Pathogens of sputum culture were positive in 4 cases (12.5%); blood cultures of pathogens were positive in 3 cases (9.4%). 27 cases were cured (84.4%), 4 cases (12.5%) were improved, the total effective rate was 96.9%. Conclusion Clinical should pay full attention to the clinical manifestations of children with NRDS and laboratory tests, early detection and early treatment to improve clinical efficacy and reduce complications.