早期使用鼻塞持续气道正压通气治疗新生儿呼吸窘迫综合征的疗效观察

朱莹雯, 丁晓春, 朱雪萍, 汪清

朱莹雯, 丁晓春, 朱雪萍, 汪清. 早期使用鼻塞持续气道正压通气治疗新生儿呼吸窘迫综合征的疗效观察[J]. 实用临床医药杂志, 2013, (7): 51-54. DOI: 10.7619/jcmp.201307016
引用本文: 朱莹雯, 丁晓春, 朱雪萍, 汪清. 早期使用鼻塞持续气道正压通气治疗新生儿呼吸窘迫综合征的疗效观察[J]. 实用临床医药杂志, 2013, (7): 51-54. DOI: 10.7619/jcmp.201307016
ZHU Yingwen, DING Xiaochun, ZHU Xueping, WANG Qing. Clinical observation of early use of nasal CPAP on neonatal respiratory distress syndrome[J]. Journal of Clinical Medicine in Practice, 2013, (7): 51-54. DOI: 10.7619/jcmp.201307016
Citation: ZHU Yingwen, DING Xiaochun, ZHU Xueping, WANG Qing. Clinical observation of early use of nasal CPAP on neonatal respiratory distress syndrome[J]. Journal of Clinical Medicine in Practice, 2013, (7): 51-54. DOI: 10.7619/jcmp.201307016

早期使用鼻塞持续气道正压通气治疗新生儿呼吸窘迫综合征的疗效观察

详细信息
  • 中图分类号: R722.12

Clinical observation of early use of nasal CPAP on neonatal respiratory distress syndrome

  • 摘要: 目的 探讨早期使用鼻塞持续气道正压通气(nCPAP)治疗极低出生体质量患儿呼吸窘迫综合征(RDS)的疗效.方法 回顾性分析99例确诊为RDS的极低出生体质量患儿的临床资料.其中,出生后2h内即开始nCPAP辅助呼吸的40例设为治疗组,出生后2h内未使用nCPAP辅助呼吸的59例设为对照组.比较2组患儿的病死率、血气及胸片变化、氧疗、并发症、住院时间、恢复出生体质量时间等指标.结果 治疗组病死率为7 5%,对照组为23.3% (P<0.05);治疗组治疗2h后血气指标改善较对照组明显,差异有统计学意义(P<0.05);治疗24、48 h后2组血气情况均有改善.在治愈的患儿中,治疗组和对照组机械通气比例分别为37.1%、64.9% (P<0.05);机械通气时间分别为(2.46±2.11)d和(6.79±2.86)d(P<0.01);总氧疗时间治疗组为(17.41±13.89)d,对照组为(28.94±12.38) d(P<0.01);治疗组和对照组住院天数分别为(40.49±10.45)d和(51.73±15.04)d(P<0.01);恢复出生体质量时间分别为(9.71±4.818)d和(13.30±4.807)d(P<0.01);支气管肺发育不良发生率分别为8.6%和29.7% (P<0.05).结论 对于极低出生体质量患儿合并RDS,早期使用nCPAP可明显降低病死率,改善近期预后,疗效安全可靠.
  • Neil N F, Waldemar A C, Michele C W. Early cpap versus surfactant in extremely preterm infants [J]. New England Journal of Medicine, 2010, (362):1970.
    邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学 [M]. 北京:人民卫生出版社, 2011.1.
    Jobe A H, Bancalari E. Bronchopulmonary dysplasia [J]. American Journal of Respiratory and Critical Care Medicine, 2001(7):1723.
    Bohlin K. RDS-CPAP or surfactant or both [J]. Acta Pdiatrica, 2012, (Suppl.464):24.
    Bohlin K, Bohaufs R K, Jarstrand C. Spontaneous breathing or mechanical ventilation alters lung compliance and tissue association of exogenous surfactant in preterm newborn rabbits [J]. Pediatric Research, 2005, (5Part1):624.
    Sweet D G, Carnielli V, Greisen G. European Consensus Guidelines on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants-2010 Update [J]. Neonatology, 2010.402.
    Sandri F, Ancora G, Lanzoni A. Prophylactic nasal continuous positive airways pressure in newborns of 28-31weeks gestation:multicentre randomised controlled clinical trial [J]. ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION, 2004(5):F394.
    Kamper J, Feilberg J N, Jonsbo F. The Danish nathonal srudy in infants with extremely low gestational age and birth weight(the ETFOL study):respiratory morbidity and outcome [J]. Acta Paediatrica, 2004.225.
    Te Pas A B, Spaans V M, Rijken M. Early nssal continuous positive airway pressure and low threshold for intubation in very preterm infants [J]. Acta Paediatrica, 2008(8):1049.
    Kirschner L, WeningerM, Unterasinger L. Is the use of early nasal CPAP associated with lower rates of chronic lung disease and retinopathy of prernaturity? Nine years of experience with the Vermont Oxford Neonatal Network [J]. PERINATAL MEDIZIN, 2005(1):60.
    Thomson M A, Yoder B A, Winte V T. Treatment of immature baboons for 28 days with early nasal continuous positive nasal pressure [J]. American Journal of Respiratory and Critical Care Medicine, 2004(9):1054.
    Henrik V, Kajsa B, Jens K. Nasal CPAP and surfactant for treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia [J]. Acta Paediatrica, 2009(9):1400.
    Jobe A H, Kramer B W, Moss T J. Decreased indicators of lung injury with continuous positive expiratory pressure in preterm lambs [J]. Pediatric Research, 2002(3):387.
    黄从付, 肖政祥, 陈诚. 使用新型NCPAP治疗极低出生体重早产儿呼吸窘迫综合征 [J]. 广东医学, 2010(5):603.
    Dani C, Bertini G, Pezzati M. Early Extubation and Nasal Continuous Positive Airway Pressure After Surfactant Treatment for Respiratory Disstress Syndrome Among Preterm Infant《 30 weeks' Gestation [J]. Pediatrics, 2004(6):e560.
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  • 发布日期:  2013-06-12

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