不同剂量肺表面活性物质联合鼻塞持续正压通气治疗新生儿呼吸窘迫综合征疗效比较

摘要

目的 探讨不同剂量肺表面活性物质联合鼻塞持续正压通气治疗新生儿呼吸窘迫综合征(NRDS)的疗效.方法 选择深圳龙华区人民医院新生儿重症监护室于2015年1月至2017年1月期间收治的124例NRDS患儿为研究对象,根据随机数表法分为观察组和对照组,每组62例,对照组、观察组患儿分别予标准剂量(100 mg/kg)及大剂量(200 mg/kg)猪肺表面活性物质联合鼻塞持续正压通气治疗,总疗程为10 d,治疗结束后比较两组患儿临床疗效及并发症发生情况.结果 观察组患儿在治疗后6 h、12 h、24 h的吸入氧浓度(FiO2)分别为(42.5±4.5)%、(41.8±4.7)%、(38.3±4.4)%,均明显低于对照组的(48.2±6.2)%、(46.4±5.1)%、(43.1±5.6)%,差异均有统计学意义(P<0.05);观察组用药次数及通气时间分别为(1.4±0.4)次、(145.2±34.2)h,均明显低于对照组的(1.9±0.6)次、(193.4±40.1)h,差异均有统计学意义(P<0.05);观察组患儿的机械通气并发症发生率为6.45%,明显低于对照组的16.13%,差异有统计学意义(P<0.05);两组患儿的死亡率比较差异无统计学意义(P>0.05).结论 大剂量肺表面活性物质联合鼻塞持续正压通气治疗新生儿呼吸窘迫综合征较常规剂量治疗可以取得更好的临床疗效.%Objective To investigate the effect of different doses of pulmonary surfactant combined with nasal continuous positive airway pressure in the treatment of neonatal respiratory distress syndrome (NRDS). Methods A to-tal of 124 cases of NRDS, who treated in the neonatal intensive care unit of our hospital from January 2015 to Janu-ary 2017, were selected and divided into the observation group and the control group according to the random number ta-ble method, with 62 cases in each group. The control group and observation group were treated, respectively with stan-dard dose (100 mg/kg) and high dose (200 mg/kg) pulmonary surfactant combined with nasal continuous positive airway pressure treatment for 10 days. After the treatment, the clinical efficacy and complications rate between two groups were compared. Results After the treatment, the fractional inspired oxygen concentration (FIO2) in the observation group at 6 h, 12 h, 24 h were (42.5 ± 4.5)%, (41.8 ± 4.7)%, (38.3 ± 4.4)%, respectively, which were significantly lower than (48.2 ± 6.2)%, (46.4±5.1)%, (43.1±5.6)%in the control group (P<0.05). The medication times, ventilation time in the observa-tion group were (1.4±0.4), (145.2±34.2) h, which were significantly lower than (1.9±0.6) and (193.4±40.1) h in the con-trol group (P<0.05). The complication rate in the observation group was 6.45%, which was significantly lower than 16.13%in the control group (P<0.05). There was no significant difference between the two groups in mortality rate (P>0.05). Conclusion The high dose pulmonary surfactant combined with continuous positive airway pressure can achieve better clinical efficacy than conventional dose treatment in the treatment of NRDS.