肺复张策略在新生儿呼吸窘迫综合征中的应用效果

摘要

Objective To explore the application effect of lung recruitment maneuver on neonatal respiratory distress syndrome ( DRS) .Methods Fifty neonates with RDS were divided into control group and observation group using the random number table ,with 25 cases in each group .The routine integrated treatment ,pulmonary surfactant and mechanical ventilation were performed in both groups .Lung recruitment maneuver was not conducted in the control group but was performed in the observation group .The clinical therapeutic efficacy was compared between the two groups .Results In both groups,PaO2 and oxygenation index (OI) increased but PaCO2 and fraction of inspired oxygen(FiO2) decreased with the increase of the observation time (P<0.05).After 12 and 24 hours of lung recruitment,PaO2 and OI were higher but PaCO2 and FiO2 were lower in the observation group compared to the control group (P<0.05).The usage count of pulmonary surfactant in the observation group was less than that in the control group , the durations of oxygen inhalation and respiratory support by intubation,and the total duration of respiratory support in the observation group were shorter than those in the control group (all P<0.05). There were no significant differences in the numbers of cases failed in extubation or cases of bronchopulmonary dysplasia between the two groups (P>0.05).Conclusion Lung recruitment maneuver can improve the respiratory function of the neonates with RDS more effectively as well as the therapeutic effect .And this approach is safe and reliable .%目的 探讨肺复张策略在新生儿呼吸窘迫综合征(RDS)中的应用效果.方法 将50例RDS新生儿按随机数字表法分为对照组和观察组各25例,均给予常规综合治疗及肺表面活性物质、机械通气治疗,对照组不采用肺复张策略,观察组采用肺复张策略,观察比较两组患儿临床治疗效果.结果 两组的PaO2、氧合指数(OI)均随观察时间延长而上升,PaCO2、吸入氧浓度(FiO2)均随观察时间延长而下降(P<0.05),且复张后12 h及24 h,观察组PaO2、OI均高于对照组(P<0.05),PaCO2、FiO2均低于对照组(P<0.05).观察组肺表面活性物质使用次数少于对照组,吸氧时间、插管呼吸支持和总呼吸支持时间均短于对照组(均P<0.05);两组拔管失败和支气管肺发育不良例数比较,差异无统计学意义(P>0.05).结论 肺复张策略治疗能更有效地改善RDS新生儿的呼吸功能,提高治疗效果,且安全可靠.