CAJ | 학술논문

目的探讨早期经鼻持续气道正压(nCPAP)对28～32孕周早产儿肺透明膜病(HMD)的预防作用.方法 54例胎龄28～32周,出生体重小于1 500 g的早产儿在生后30 min内无论有无缺氧均用nCPAP进行呼吸管理,观察HMD的发生率及外源性肺表面活性物质(PS)和机械通气的应用率.结果观察组HMD的发生率为44%(24/54),明显低于对照组的69%(33/48),P＜0.05,差异有显著性意义,但Ⅲ～Ⅳ级HMD的发生率,两组相比差异无显著性意义,(P＞0.05);观察组30%(16/29)需应用PS,明显少于对照组的50%(24/48),差异有显著性意义P＜0.05;机械通气率及颅内出血的发病率两组相比差异均无显著性意义(P＞0.05).结论早期nCPAP对28～32孕周早产儿发生HMD有一定的预防作用,能减少外源性PS的应用,但不减少对机械通气的需要.
목적 탐토조기경비지속기도정압(nCPAP)대28～32잉주조산인폐투명막병(HMD)적예방작용.방법 54례태령28～32주,출생체중소우1 500 g적조산인재생후30 min내무론유무결양균용nCPAP진행호흡관리,관찰HMD적발생솔급외원성폐표면활성물질(PS)화궤계통기적응용솔.결과 관찰조HMD적발생솔위44%(24/54),명현저우대조조적69%(33/48),P＜0.05,차이유현저성의의,단Ⅲ～Ⅳ급HMD적발생솔,량조상비차이무현저성의의,(P＞0.05);관찰조30%(16/29)수응용PS,명현소우대조조적50%(24/48),차이유현저성의의P＜0.05;궤계통기솔급로내출혈적발병솔량조상비차이균무현저성의의(P＞0.05).결론 조기nCPAP대28～32잉주조산인발생HMD유일정적예방작용,능감소외원성PS적응용,단불감소대궤계통기적수요.
Objective To explore the prophylactic effect of early nasal continuous positive airways pressure(nCPAP) on hyaline membrane disease(HMD) in preterm infants of 28～32 weeks gestation. Methods Prophylactic nCPAP commenced within 30 minutes after birth regardless of oxygen requirement for respiratory management in 54 cases preterm infants of 28～32 weeks gestation and the birth weights less than 1 500 g,to observe the incidence of HMD and the need for exogenous pulmonary surfactant(PS) and mechanical ventilation as well. Results The incidence of HMD in observed group was significantly lower than that of control group(44% vs 69%,P＜0.05),but the incidence of grade Ⅲ～Ⅳ HMD was not significant difference between the two groups(P＞0.05). However, that the need for exogenous PS in observed group was significantly fewer than in control group(30% vs 50%,P＜0.05),while no significant difference at the incidence of intracranial hemorrhage and the rate of mechanical ventilation were found(P＞0.05).Conclusion The usa of early nCPAP maybe have some benefits as prophylaxis for HMD and reduce the need for exogenous PS,not for mechanical ventilation,in preterm infants of 28～32 weeks gestation.