持续气道正压通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征的效果

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目的探讨持续气道正压通气(CPAP)联合肺表面活性物质(PS)治疗新生儿呼吸窘迫综合征(NRDS)的效果。方法选取2014年5月-2016年5月收治的68例NRDS患儿为研究对象,按照治疗方法不同分为观察组(38例)和对照组(30例)。对照组患儿给予PS治疗,观察组患儿给予CPAP联合PS治疗。比较两组患儿血气分析结果、临床疗效及并发症发生率。结果观察组治疗前后动脉血二氧化碳分压(PaCO_2)、氧分压(PaO_2)、p H值、氧合指数(PaO_2/FiO_2)比较,差异均有统计学意义(P<0.05)。对照组治疗前后PaCO_2、PaO_2、p H值、PaO_2/FiO_2比较,差异均有统计学意义(P<0.05)。治疗后,观察组与对照组PaCO_2、PaO_2、p H值、PaO_2/FiO_2比较,差异均有统计学意义(P<0.05)。观察组患儿的总有效率高于对照组,差异有统计学意义(P<0.05)。观察组患儿的住院时间显著短于对照组,住院费用显著低于对照组,差异均有统计学意义(P<0.05)。观察组患儿支气管肺发育不良发生率显著低于对照组,差异有统计学意义(P<0.05);两组患儿气胸、坏死性小肠结肠炎、视网膜病发生率比较差异均无统计学意义(P>0.05)。结论 CPAP联合PS治疗NRDS能有效改善患儿肺功能,减少相关并发症,提高治疗效果。 Objective To investigate the effect of continuous positive airway pressure (CPAP) combined with pulmonary surfactant (PS) on neonatal respiratory distress syndrome (NRDS). Methods A total of 68 children with NRDS admitted from May 2014 to May 2016 were selected as study object and divided into observation group (38 cases) and control group (30 cases) according to different treatment methods. Children in the control group were treated with PS, and children in the observation group were treated with CPAP combined with PS. Blood gas analysis results, clinical efficacy and incidence of complications in both groups were compared. Results Before and after treatment, the PaCO 2, PaO 2, p H and PaO 2 / FiO 2 in the observation group were significantly different (P <0.05). PaCO_2, PaO_2, p H values ​​before and after treatment in the control group, PaO_2 / FiO_2, the difference was statistically significant (P <0.05). After treatment, the PaCO_2, PaO_2, p H values ​​and PaO_2 / FiO_2 in the observation group and the control group were significantly different (P <0.05). The total effective rate in observation group was higher than that in control group, the difference was statistically significant (P <0.05). The hospitalization time of the observation group was significantly shorter than that of the control group, and the hospitalization expense was significantly lower than that of the control group (P <0.05). The incidence of bronchopulmonary dysplasia in the observation group was significantly lower than that in the control group (P <0.05). There was no significant difference in the incidence of pneumothorax, necrotizing enterocolitis and retinopathy among the two groups (P> 0.05). Conclusion CPAP combined with PS treatment of NRDS can effectively improve children’s lung function, reduce the related complications and improve the therapeutic effect.
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