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目的观察并对比传统方法和改良法注入肺表面活性物质(PS)治疗早产儿呼吸窘迫综合征(RDS)的临床疗效。方法回顾性分析2012年1月至2013年10月我科收治并应用PS治疗的RDS早产儿,根据PS注入方法不同分为传统组和改良组。传统方法为断开气管插管与呼吸机,将PS注入气管插管内;改良法为不断开气管插管与呼吸机,将PS通过注射器针头刺入气管插管内。对比两组患儿使用PS时血氧饱和度(Sp O2)、心率、药物反流情况,用药后患儿胸部X线结果,以及两组患儿治疗时间。结果改良组共纳入36例,传统组共纳入35例,两组患儿基础情况差异无统计学意义(P>0.05)。改良组注药过程中Sp O2高于传统组[(90.1±5.6)%比(86.6±7.4)%],药物反流发生率低于传统组(2.8%比60.0%),用药后4~6 h复查胸部X线片,好转比例高于传统组(88.9%比68.6%),机械通气及总需氧时间短于传统组[(3.2±1.5)天比(5.0±2.9)天,(5.9±2.2)天比(8.2±3.7)天],差异均有统计学意义(P<0.05)。两组气漏发生率差异无统计学意义(P>0.05)。结论采用改良法注入PS治疗早产儿RDS可有效缓解呼吸困难及缺氧症状,改善肺部情况,缩短机械通气时间及需氧时间。
Objective To observe and compare the clinical efficacy of the traditional method and the modified method of pulmonary surfactant (PS) in the treatment of respiratory distress syndrome (RDS) in preterm infants. Methods Retrospective analysis was performed on preterm infants with RDS admitted to our department from January 2012 to October 2013 and treated with PS. According to the PS injection method, the patients were divided into the traditional group and the modified group. The traditional method is to disconnect the endotracheal intubation and ventilator, the PS into the endotracheal intubation; improved method for the continuous open endotracheal intubation and ventilator, the PS through the syringe needle pierce the endotracheal intubation. The blood oxygen saturation (Sp O2), heart rate, drug reflux, the chest X-ray results after treatment and the treatment time of two groups were compared between the two groups. Results In the improved group, 36 cases were enrolled and 35 cases were enrolled in the traditional group. There was no significant difference in basic conditions between the two groups (P> 0.05). SpO2 in the modified group was significantly higher than that in the traditional group [(90.1 ± 5.6)% vs (86.6 ± 7.4)%], and the incidence of reflux was lower than that in the traditional group (2.8% vs 60.0% (88.9% vs 68.6%), mechanical ventilation and total aerobic time were shorter than that of the conventional group [(3.2 ± 1.5) days vs (5.0 ± 2.9 days, (5.9 ± 2.2) day ratio (8.2 ± 3.7) days, the differences were statistically significant (P <0.05). There was no significant difference in the incidence of air leakage between the two groups (P> 0.05). Conclusion Injection of modified PS into preterm infants treated with RDS can effectively alleviate the symptoms of dyspnea and hypoxia, improve lung conditions and shorten the duration of mechanical ventilation and aerobic time.