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目的探讨足月剖宫产儿呼吸窘迫综合征(NRDS)予肺表面活性物质(PS)及无创呼吸机辅助通气治疗的效果分析。方法对符合条件的44例足月儿和108例早产儿(<34周,49例,34～36+6周59例),在高危因素、使用PS的量及时间、予NCPAP治疗的时间、持续时间、用氧的时间,及机械通气的例数进行对照分析。结果①三组间剖宫产率差异有统计学意义,随胎龄增加,剖宫产率明显增加;高危因素中:早产儿组以宫内窘迫,产时窒息,胎膜早破,前置胎盘为主要原因,足月组以宫内窘迫,脐带绕颈,产时窒息占前3位。②给予PS的量三组间比较差异无统计学意义(P>0.05),给予PS的时间三组间比较差异有统计学意义(P<0.01),给予NCPAP治疗的时间三组间比较差异有统计学意义(P<0.05),NCPAP治疗持续的时间和用氧时间三组间比较差异无统计学意义(P>0.05)。三组需要机械通气的比较差异无统计学意义(P>0.05)。结论足月儿剖宫产儿NRDS以未发作的选择性剖宫产导致继发性缺乏肺表面活性物质为主要原因,其给予PS的时间和予NCPAP治疗的时间较早产儿要晚,NCPAP持续的时间和用氧时间以及需要机械通气治疗的比例较早产儿比较差异无统计学意义。尽早对足月儿NRDS予PS加NCPAP治疗,可提高足月儿NRDS治愈率和成活率,改善预后。
Objective To investigate the effect of respiratory distress syndrome (NRDS) on pulmonary surfactant (PS) and noninvasive ventilator-assisted ventilation in term cesarean section. Methods Forty-four eligible term children and 108 premature infants (<34 weeks, 49 cases, 34 to 36 + 6 weeks) were enrolled in this study. The risk factors, the amount and time of PS administration, the duration of treatment with NCPAP, Duration, time spent on oxygen, and the number of cases of mechanical ventilation were analyzed. Results ① There was a significant difference in cesarean section rate among the three groups, with the increase of gestational age, the rate of cesarean section increased significantly. Among the high risk factors, the rate of cesarean section, preterm premature rupture of membranes, The main reason for the placenta, term group to intrauterine distress, umbilical cord around the neck, birth asphyxia accounted for the first three. (2) There was no significant difference in the amount of PS among the three groups (P> 0.05), and there was significant difference between the three groups in the time of PS administration (P <0.01). The time of NCPAP treatment was Statistical significance (P <0.05), NCPAP duration of treatment and oxygen use time between the three groups showed no significant difference (P> 0.05). There was no significant difference between the three groups in requiring mechanical ventilation (P> 0.05). Conclusions NRDS of full-term children with unexplained cesarean section leads to secondary lack of pulmonary surfactant as the main reason for the administration of PS and NCPAP to NPSAP Of the time and oxygen time and the need for mechanical ventilation treatment compared with the rate of preterm children no significant difference. As soon as possible to full-term children with NRDS PS plus NCPAP treatment, can improve full-term children NRDS cure rate and survival rate, improve the prognosis.